西宁地区原发性肾病综合征临床特点及并发症与病理类型相关因素研究  

Clinical Characteristics of Primary Nephrotic Syndrome Correlated with Pathological Type Factors in Xining Area

作　　者：高森森 陈碧琴[1] 刘佩[2] 

机构地区：[1]青海大学附属医院,810001 [2]四川省疾病预防控制中心,610041

出　　处：《青海医药杂志》2017年第3期6-9,共4页Qinghai Medical Journal

摘　　要：目的:研究西宁地区原发性肾病综合征临床特点与病理分型之间的关系,为西宁地区原发性肾病综合征的诊疗提供依据,临床病理诊断提供指导性意见。方法:收集青海大学附属医院肾内科2011年1月—2016年3月期间,收治的151例原发性肾病综合征并行肾活检且临床资料齐全的患者,分析患者临床病理类型与临床特点及并发症的关系,进而探讨二者之间的联系。结果:本组151例患者,男女比例1:1;病理类型构成:膜性肾病45.03%、微小病变性肾病15.89%、系膜增生性肾小球肾炎25.83%、系膜毛细血管性肾小球肾炎4.64%、局灶节段性肾小球硬化8.61%,汉族、藏族、回族在病理类型分布上没有差异。结论:西宁地区原发性肾病综合征患者中,整体上男女比例相等,但中老年患者发生肾病综合征中以膜性肾病及局灶、节段硬化性肾小球肾炎发病率最高。主要临床表现除蛋白尿、浮肿,还出现高胆固醇、高甘油三脂血症、高尿酸血症、血肌酐升高。研究表明此些指标的变化与肾脏组织病理类型相关,提示积极控制高血压、高血脂、高尿酸,延缓肾功能减退进展,可有助于减轻肾脏病理损害。急性肾损伤是原发性肾病综合征中常见的并发症之一。Objective.The aim of this paper is to study the clinical characteristics of primary nephrotic type and the relationship with pathological syndrome in Xining area, provide guidance for clinical and pathological diagnosis. Methods. 151 patients who had been treated in Affiliated Hospital of Qinghai University during January 2011 to March 2016 because of the primary nephrotic syndrome and renal biopsy parallel were collected to analyze the clinical data and biopsy results and study the relationship between clinical pathology and clinical features with complica- tions. Result.In 151 cases, the female ratio is 1 ： 1. The pathological types are. membranous nephropathy 45.030%; non--type IgA mesangial proliferative glomerulonephritis 25.83%; minimal change nephropathy 15.89%; focal segmental glomerulosclerosis 8.61% and IgA nephropathy 4.64^. As to Han and ethnic minorities （Tibetan and Hui）, there was no difference in the pathology type distribution.Conclusion. Among the patients with primary ne- phrotic syndrome in Xining, the overall proportion of men and women are equal. But among mid--aged people there is a high rate of primary nephrotic syndrome; membranous nephropathy; mesangial proliferative glomerulo- nephritis. The main clinical manifestations are, in addition to proteinuria and edema, high cholesterol, hypertrig- lyceridemia, hyperuricemia, and increased blood creatinine. Studies have shown that changes in these indicators are associated with the pathology of the kidney tissue type. Prompting active control of hypertension, hyperlipidemia and high uric acid and delaying the progress of renal impairment can help to reduce the renal pathological damage. Acute kidney injury is a common complication in patients with primary nephrotic syndrome.

关 键 词：原发性肾病综合征 病理类型 临床特点 并发症 

分 类 号：R692[医药卫生—泌尿科学] R365[医药卫生—外科学]