病因不明急性肾衰竭患者肾活检的临床意义  

Significance of renal biopsy in unknown causes of acute renal failure

作　　者：李婷[1] 孙彬[1] 刘佳[1] 毛慧娟[1] 钱军[1] 赵秀芬[1] 徐琳[1] 邢昌赢[1] 

机构地区：[1]南京医科大学第一附属医院肾脏病科,210029

出　　处：《江苏医药》2011年第17期2031-2034,共4页Jiangsu Medical Journal

摘　　要：目的探讨急性肾衰竭(ARF)的病理类型、临床特点以及影响肾脏转归的因素。方法回顾性分析50例因ARF行肾穿刺活检患者的临床和病理资料。结果 50例患者中,年龄、血清白蛋白、血红蛋白、血清胱抑素和ATN-ISI评分是影响肾脏转归的临床因素。ARF患者的病理学类型包括肾小球疾病(40.0%)、肾小管-间质病变(50.0%)、继发性肾脏病如血管炎及狼疮性肾炎等(10.0%)。急性间质性肾炎和急性肾小管坏死是ARF最常见的原因。肾脏转归最好的是肾小管-间质病变,其肾功能恢复率达56.0%;最差的是新月体肾炎和血管炎,肾功能恢复率分别为9.1%和0。新月体肾炎、ATN-ISI评分和血清胱抑素是影响肾脏预后危险度的因素。结论 ARF病理类型多样,预后与病理类型密切相关;尽早进行肾活检对于确定病理类型和病变程度,选择合适的治疗方案有重要价值。Objective To analyze the histopathologic and clinical characteristics of 50 cases with acute renal failure（ARF）.Methods The clinical and pathological data of 50 ARF patients underwent renal biopsy were analyzed retrospectively.Results The factors to influence the prognosis were age,serum albumin,Hb,CYS and ATN-ISI score.Histopathologic lesions included glomerular disease（40.0%）,tubular interstitial disease（50.0%） and secondary renal diseases（vasculities,microangiopathy,etc.,10.0%）.The most common pathology associated with ARF was acute interstitial nephritis and acute tubular necrosis.The percentage of complete recovery was 56.0% in patients with acute interstitial nephritis and acute tubular necrosis.The percentages of complete recovery were 9.1% for crescentic glomerulonephritis and 0 for vasculitis.The crescentic glomeru-lonephritis,CYS and ATN-ISI score were the factors for predicting the prognosis of patients with ARF.Conclusion ARF has varied pathological types,which influence the prognosis of ARF.Early renal biopsy banefits typing pathologically,evaluating the severity and guiding therapy of ARF.

关 键 词：急性肾衰竭 肾活检 

分 类 号：R692[医药卫生—泌尿科学]