原、继发性膜增殖性肾炎的临床病理对比分析  

Clinicopathological contrast analysis between primary and secondary membranoproliferative glomerulonephritis

作　　者：谭敏[1] 谌贻璞[1] 

机构地区：[1]北京大学中日友好临床医学院（中日友好医院）肾病中心,北京100029

出　　处：《临床肾脏病杂志》2009年第12期539-542,共4页Journal Of Clinical Nephrology

摘　　要：目的探讨原、继发性膜增殖性肾小球肾炎（MPGN）的临床病理特点。方法对全部MPGN患者的临床表现、实验室检查及病理表现（包括病理半定量检查）进行回顾性对比分析。结果原发性MPGN仅占全部肾活检病例的0．27％。继发性MPGN主要为膜增殖性狼疮性肾炎（MPGN—LN）、乙型肝炎病毒相关膜增殖性肾炎（HBV-MPGN）、膜增殖性IgA肾病（MPGN-IgAN）及原因不明MPGN。与原发性MPGN比较，MPGN—LN、HBV-MPGN及原因不明MPGN患者的肾病综合征患病率高，MPGN-IgAN患者肾功能损伤重。前三者光镜下均可见“白金耳”，免疫荧光“满堂亮”，电镜检查电子致密物多部位沉积；而MPGN—IgAN患者的肾小球损伤指数及肾小管间质损伤指数最高。结论继发性MPGN与原发性MPGN在临床及病理方面有所不同。Objective To investigate the clinicopathological features of primary and secondary membranoproliferative glomerulonephritis（MPGN）. Methods The clinical,laboratory and pathological manifestations including the semiquantitative pathological examination of all MPGN patients were ret rospectively analyzed and compared. Results Of all the renal biopsies,primary MPGN only accounted for 0. 27%. The secondary MPGN in this study mainly consisted of MPGN LN, HBV-MPGN, MPGN-IgAN and MPGN with unknown etiology. Compared with primary MPGN, nephrotic syndrome was more popular in MPGN-LN, HBV-MPGN and MPGN with unknown etiology,and renal function im pairment was more serious in MPGN-IgAN. ＂Wire loop＂ under the light microscopy, ＂full house＂ by immunofluorescence examination and electron-dense deposits of various sites under the electron micros copy were commonly seen in the MPGN LN, HBV-MPGN and MPGN with unknown etiology. The glomerular and tubulointerstitial damage indexes were the highest in MPGN IgAN. Conclusions There are differences in clinical and pathological manifestations between primary and secondary MPGN.

关 键 词：肾小球肾炎 膜增生性 病理学 狼疮肾炎 

分 类 号：R692.3[医药卫生—泌尿科学] R735.2[医药卫生—外科学]