狼疮性肾炎肾穿刺活检112例临床病理分析  

Lupus nephritis: a clinicopathological analysis of 112 renal biopsy cases

作　　者：隋燕霞[1] 孙涛[2] 杨喆[1] 李晓锋[1] 王鸿雁[1] 张冠军[1] 

机构地区：[1]西安交通大学医学院第一附属医院病理科,西安710061 [2]西安交通大学医学院药理系,西安710061

出　　处：《诊断病理学杂志》2013年第12期763-766,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨狼疮性肾炎(LN)的临床病理特点。方法回顾性分析112例狼疮性肾炎的临床及肾穿刺活检标本的病理特征与分型的关系。结果 112例中女性99例,男性13例。年龄5～69岁,平均(31.8±11.5)岁。LN的病理形态多种多样,肾小球可表现为系膜增生、毛细血管内增生、膜增生、基底膜增厚、纤维素样坏死、新月体形成、肾小球硬化;肾小管可有不同程度的变性、坏死;间质可有炎细胞浸润及纤维化。按国际肾病学会和肾脏病理学会工作组LN(2003)的病理分类方案,分为8型。112例LN的分型为Ⅰ型1例,轻微病变性LN;Ⅱ型12例,系膜增生性LN;Ⅲ型17例,局灶性LN;Ⅳ型38例,弥漫性LN;Ⅴ型15例,为膜性LN;Ⅲ+Ⅴ型8例,为Ⅲ型合并Ⅴ型的LN;Ⅳ+Ⅴ型20例,为Ⅳ合并Ⅴ的LN;Ⅵ型1例,为严重硬化性LN。病理类型以Ⅳ型最常见。结论肾组织活检病理学诊断是确诊狼疮性肾炎的可靠方法,可以为临床的治疗及判断预后提供可靠的形态学依据。Objective To evaluate the clinicopathological characteristics of the lupus neghritis（ LN）. Methods The clinical and kidney puncture biopsy data were assessed and the relationship between clinical characteristics and pathological types were retrospectively analyzed in 112 renal biopsy cases. Results In the 112 patients,99 were female,while 13were male. The age of patients was from 5 to 69 years,and the average age was 31. 83 ± 11. 54 years. The pathological patterns of LN were various： the pathological changes in glomerulus showed mesangial proliferation, endocapillary proliferation,membrane proliferation,thickening of basement membrane, fibrinoid necrosis, crescent formation and glomerular sclerosis,and the pathological changes in renal tubules displayed different degrees of deformation and necrosis,while inflammatory cells infiltration and fibrosis were also found in interstition. All the cases erer divided into 8 types according to pathological classification of LN（ 2003）. The pathological tupes of the 112 cases of LN showed as follows： 1case of typeⅠ was slight pathological changes of LN,12 cases of type Ⅱ were mesangioproliferative LN,17 cases of typeⅢ were focal LN,38 cases of type Ⅳ were diffuse LN,15 cases of type Ⅴ were membranoproliferative LN,8 cases of typeⅢ ＋ Ⅴ were type Ⅲ combined and typeⅤ LN,20 cases of type Ⅳ ＋ Ⅴ were were type Ⅳ combined and typeⅤ LN,1case of type Ⅵ was sclerosing LN. The most commom pathological type of LN was type Ⅳ. Conclusions LN has complex pathological changes and varied clinical characteristics. Renal biopsy pathologic diagnosis of LN is a reliable method for clinical treatment and prognostc evaluation.

关 键 词：狼疮性肾炎 肾活检 病理学 

分 类 号：R732.2[医药卫生—肿瘤]