10年前后原发性肾小球病的临床和病理分型特点分析  

The clinical and pathological spectrum of primary glomerular disease in the last decade： changing or not

作　　者：胡小红[1] 钱一欣[1] 陶煜[1] 杨明[1] 吴俊[1] 张玉强[1] 叶朝阳[1] 郁胜强[1] 

机构地区：[1]第二军医大学附属长征医院肾内科,上海200003

出　　处：《临床肾脏病杂志》2012年第12期545-548,共4页Journal Of Clinical Nephrology

摘　　要：目的了解10年前、后原发性肾小球病的临床病理类型分布及变化的特点。方法收集2001年1月至2002年6月（10年前）以及2011年1月至2012年6月（10年后）行肾穿刺活检并确诊原发性肾小球病患者的资料，对青、中、老年组进行统计分析。结果（1）10年来我科行肾穿刺的中老年人所占比例明显上升。（2）10年前、后临床分型均以慢性肾小球肾炎最常见，其次是。肾病综合征。不同年龄组肾病综合征比例随着年龄增加而上升，慢性肾小球肾炎则相反。（3）IgA肾病、膜性肾病和局灶节段性肾小球硬化均较10年前明显增加。膜性肾病比例随年龄增加呈升高趋势。微小病变则相反。结论10年来行肾穿刺的中老年人所占比例上升，原发性肾小球病临床分型分布无明显变化，病理分型分布发生变化，且不同年龄组病理类型存在差异。Objective The aim is to investigate the changing clinical and pathological spectrum of primary glomerular disease in the last decade. Methods The records of renal biopsies between Janu- ary 2001 to June 2002（period 1） and January 2011 to June 2012（period 2） were analysed. Then they were divided into 3 groups（groupl ： 18-44 years old, group 2.. 45-64 years old, group 3..65 years of age or older） if they were diagnosed as primary glomerular disease. Results （1）496 and 713 patients had renal biopsies,and the proportion of the middle-aged man rose from 25. 66% to 43. 93% and the elderly,from 3.70% to 9. 93%. （2）The leading primary glomerular disease was chronic glomerulone- phritis in period 1 and 2, followed by nephrotic syndrome. Nephrotic syndrome was more common in older people,while chronic glomerulonephritis was opposite during the same period. （3）IgA nephropa- thy,membranous nephropathy and focal segmental glomerular sclerosis significantly increased com- pared with 10 years ago. Membranous nephropathy was more common in older people in either group, while glomerular minimal change was the opposite. ConclUsions The relative frequency of middle-aged and eldly increased significantly. The clinical spectrum was almost the same in decade while pathological spectrum was different. There were differences pathological types of different age groups.

关 键 词：肾病综合征 发病年龄 老年人 

分 类 号：R692.6[医药卫生—泌尿科学]