10594例肾活检病理资料分析  

ANALYSIS OF 10 594 RENAL BIOPSY DATA

作　　者：陈惠萍[1] 曾彩虹[1] 胡伟新[1] 王庆文[1] 俞雨生[1] 姚小丹[1] 唐政[1] 王建平[1] 朱茂艳[1] 周虹[1] 刘红[1] 刘志红[1] 黎磊石[1] 

机构地区：[1]南京军区南京总医院解放军肾脏病研究所,南京210002

出　　处：《肾脏病与透析肾移植杂志》2000年第6期501-509,共9页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的 :回顾性分析南京军区南京总医院 1979年 1月～ 2 0 0 0年 10月 10 5 94例因肾脏疾病行经皮肾活检者的病理类型 ,并比较前后 10年间病理类型的变化。　 方法 :参照WHO(1982年及改良的 1995年 )肾小球疾病组织学分型修订方案 ,结合临床资料、实验室检查结果、免疫病理及超微结构改变特点 ,提出诊断设想 ,然后与临床医师共同讨论明确诊断。　 结果 :本组 10 0 0 2例肾脏疾病患者行肾活检时的平均年龄 31.4± 13.0 (范围 1～ 78)岁 ,男女之比 1 30∶1;5 92例移植肾活检患者活检时的平均年龄为 37.5± 9.1(范围 16～ 6 6 )岁 ,男女之比为 2 .36∶1。除外移植肾活检者 ,本组原发性肾小球疾病占 70 .5 8% ,继发性肾小球疾病占 2 2 .82 % ,遗传性和先天性肾脏疾病占1 0 1% ,小管间质性疾病占 3 .18% ,新发现和罕见的肾脏疾病占 0 .15 % ,终末期肾脏疾病占 0 .96 % ,未分类者占1 30 %。原发性肾小球疾病以IgA居多 (39.5 5 % ) ,其次分别为系膜增生性病变 (2 9.78% ) ,膜性肾病 (9.5 4% ) ,FSGS(5 .82 % )……。最常见的继发性肾脏病变是狼疮性肾炎 (5 7.78% )。近 10年来 ,继发性肾小球疾病的检出率逐渐增高。分析前后 10年间各种原发及继发性肾脏病的检出率 ,证实近 10年来IgA肾病、膜性肾病明显增多Between January 1979 and October 2000 in Jinling Hospital (Nanjing,China),10 594 attempts of percutaneous renal biopsy were performed in renal patients from 33 provinces of China, including 592 renal transplant recipients. In this report, the pathologic entities were analyzed retrospectively, and the pathologic demography between 1979～1989 and 1990～1999 was compared. METHODOLOGY Pathological classifications were made according to the WHO criteria of 1982 for renal pathology or the modified WHO criteria of 1995 by a panel of pathologists and nephrologists in routine clinical pathological rounds. RESULTS The mean age at renal biopsy was 31.4±13.0 (1～78) years in 10 002 patients with renal diseases with a male tofemale ratio of 1.30∶1,and was 37.5±9.1(16～66) years in 592 renal transplant recipients with a male to female ratio of 2 36∶1. Primary glomerular diseases(PGD) accounted for 70 58% of the total renal patients biopsied, secondary glomerularnephritis(SGN) 22.82%, hereditary and congenital renal diseases 1.01%, tubular interstitial diseases 3.18% and,recently realized or rare renal diseases 0 15%, end stage renal diseases 0.96%, and unclassified renal diseases 1.30%. IgAN was the most frequent patholigic type(39.55%) of PGD,followed by mesangial proliferative lesion (MsPL)(29 78%), membranous nephropathy(MN)(9.54%), focal segmental glomerulosclerosis (FSGS)(5.82%). The most frequent type of SGN was lupus nephritis (LN)(57.78%). Along the 22 years, there was a stead increment of patients with SGN in pathological evaluation of renal disorders. An increment of prevalence was found in IgA nephropathy, MN(both P <0.001), crescentic glomerulonephritis ( P <0.0001), anti GBM disease, and HUS/TTP related renal damages(both P <0.001),and a decrement in EnPGN( P <0.001), IgMN( P <0.01) over 1990～1999 as compared with those during 1979～1989. The pathological entities related with acute and chronic renal failure were analyzed, with IgA nephropathy accounted for 26.7% and renal

关 键 词：肾活检 回顾性分析 病理分型 肾疾病 

分 类 号：R446.8[医药卫生—诊断学]