54例原发ANCA相关性小血管炎的肾脏病理及预后的分析  

Study on renal pathologic characteristics with functional outcoming of 54cases of ANCA-associated vasculitis patient

作　　者：薛超[1] 卜昆鹏[1] 廖蕴华[1] 

机构地区：[1]广西医科大学第一附属医院肾内科,广西南宁530021

出　　处：《中国实验诊断学》2011年第9期1528-1530,共3页Chinese Journal of Laboratory Diagnosis

基　　金：广西科学基金(桂科青0728060);广西卫生厅自筹课题(z200788);广西医科大学校博士启动基金(308019)

摘　　要：目的探讨原发小血管炎肾脏病理特点及与肾功能预后的关系。方法 54例确诊并行肾活检的原发AN-CA相关小血管炎患者,分别按年龄及性别分组,对比统计各组病理类型和病理特点并随访。结果①肾脏病理类型检出率最高的是硬化性和轻度系膜增生性肾炎各占22.2%,其次是局灶节段硬化性肾炎(18.5%);60岁以上组轻度系膜增生的患者比例偏高,P=0.05;②肾脏病理急慢性损害检出率较高为:中重度间质炎细胞浸润(48.1%),中重度间质小管损害(46.3%),纤维新月体(38.9%),中重度增生硬化(35.2%),细胞性新月体(24.1%),袢坏死检出率(14.8%);各年龄段相比,中重度增生硬化在30岁以下检出率相对较高,差异有统计学意义,P<0.05;③随访1年,9例进入尿毒症期(16.7%)。发生尿毒症的相关风险是肾脏慢性指数,P<0.05。结论肾小球硬化及严重的肾脏病理损害发生率高尤以年轻患者多见;发生终末期肾的相关风险因素是肾脏慢性指数。Objective To investigate renal pathologic characteristic and the relationship with renal function prognosis of ANCA-associated vasculitis.Methods 54cases of final diagnosed primary ANCA-associated vasculitis patient with renal biopsy were observed,groups were divided by age stage and sex,their renal pathologic diagnoses and characteristics were analysed,the patients were followed up.Results ① The highest detection rates of renal pathological type were sclerosing and mild mesangial proliferative glomerulonephritis（22.2%）.higher proportion of mild mesangial proliferative nephritis in 60 years old group,P=0.05;②The rate of renal impairment in the order：interstitial inflammatory cell infiltration（48.1%）,moderate to severe interstitial tubular damage（46.3%）,fiber crescents（38.9%）,and severe sclerosis（35.2%）,cellular crescents（24.1%）,loop detection rate of necrosis（14.8%）;all ages,moderate and severe sclerosis rate was relatively higher in the under 30 yearsgroup,P〈0.05;③ Patients were followed up 1 year,9 cases into uremia（16.7%）,risks associated with occurrence of uremia in chronic kidney index,P〈0.05.no correlation with AI,age,gender,P〉0.05.Conclusion Yunger might be with more severe glomerular sclerosis rate.higher incidence of severe renal damage should be care of;Kidney chronic index was related to end-stage renal.

关 键 词：ANCA相关性小血管炎 肾脏 病理 

分 类 号：R692[医药卫生—泌尿科学] R593.2[医药卫生—外科学]