西藏高原地区与内地平原地区肾活检病理资料对比  

Comparison of the renal disease at the Tibetan plateaus and plain based on renal biopsy data

作　　者：周岩[1] 邓永明[2] 李川[2] 龚运兵[2] 毛志国[3] 吴俊[3] 李素芝[2] 刘志红[1] 唐政[1] 

机构地区：[1]南京军区南京总医院国家肾脏疾病临床医学研究中心全军肾脏病研究所,南京210002 [2]西藏军区总医院肾脏内分泌科 [3]第二军医大学上海长征医院解放军肾脏病研究所

出　　处：《中华肾脏病杂志》2014年第6期419-423,共5页Chinese Journal of Nephrology

摘　　要：目的探讨我国西藏高原地区与内地平原地区慢性肾脏病患者肾脏病理类型特点的差异。方法采用回顾性对照研究，比较西藏高原地区80例与内地平原地区160例肾活检患者的一般情况及病理类型分布特点，以及病理与临床表现的关系。结果（1）高原组与平原组男女比例存在明显差异（0．60：1比1.11：1，P〈0．01）。（2）两组患者的病理类型分布存在明显差异，高原地区的原发性肾小球肾炎以微小病变为主（51．39％比14．53％，P〈0．01），而平原地区则以IgA肾病为主（49．57％比6．94％，P〈0．01），同时继发性肾小球肾炎中狼疮肾炎（LN）比例明显低于平原组（12．6％比34．9％，P〈0．05）。结论西藏高原地区最常见的临床表现是肾病综合征，最常见的原发性肾小球。肾炎病理类型为微小病变，内地平原地区则以IgA肾病最为常见。西藏高原地区的继发性肾脏病以过敏性紫癜性肾炎为主，平原地区以LN为主。Objective To compare the characteristics of renal disease based on renal biopsy data between the Tibetan plateaus and the plain. Methods 160 chronic kidney diseases patients underwent renal biopsy from the plain and 80 cases from Tibet plateau were compared by parallel controlled manner. The relationship of renal pathology and clinical signs were also compared. Results （1） The male to female ratio was quite different between Tibet plateau and plain groups （0.60：1 vs 1.11 ： 1, P 〈 0.01）. （2） The distribution of pathological types between two groups was quite different. The main reason of primary renal disease at Tibet plateau was minimal change disease （51.39% vs 14.53%, P 〈 0.01）, but at plain it was IgA nephrology （49.57% vs 6.94%, P 〈 0.01）. Meanwhile, the LN ratio in the secondary glomerulonephritis at the plateau region was significantly lower than those in the plain region （12.6% vs 34.9%, P 〈 0.05）. Conclusions The most common reason of primary glomerular disease in plateau region is minimal change, and the most common clinical manifestation is nephrotie syndrome. IgA nephropathy in the plain is the most frequent primary renal disease. In terms of the secondary renal diseases, allergic purpura nephritis is dominated in the plateau region, whereas LN is frequently found in the plain.

关 键 词：活组织检查 针吸 病理学 临床 高原 

分 类 号：R692[医药卫生—泌尿科学]