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男性，38岁，上呼吸道感染后，以急性肾炎综合征起病(少尿、血尿、蛋白尿、高血压、肾功能轻度损害)，伴水肿，约2，水肿加重，尿蛋白定量每日为4．0g，非选择性，时伴肉眼血尿，光镜检查红细胞在30～40个／HP，补体C3下降，血压未改变，血Cr为200μmol/L，血循环免疫复合物(+)，遂给予泼尼松治疗8，补体仍低下，ds-DNA和抗核抗体(-)，血清免疫球蛋白测定结果正常此时临床诊断应考虑为A、急性链球菌感染后肾小球肾炎 B、系膜增生性肾炎(非IgA性) C、IgA肾病 D、急进性肾炎 E、系膜血管性肾炎 此例施行肾活检，其结果最可能的是A、广泛新月体形成(>50％) B、弥漫性系膜内皮细胞增生性肾炎 C、系膜严重增生，插入内皮下，形成'双轨征' D、系膜增生伴IgG为主的沉积 E、系膜增生伴IgA为主的沉积 此时可能有益的治疗是A、长期隔日泼尼松30～40mg口服 B、隔日泼尼松30～40mg治疗3～6个月 C、血浆置换 D、对症治疗 E、甲泼尼龙冲击治疗
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