肾病综合征1077例肾脏活检病理分析  

Analysis of renal pathological features of biopsies in 1077 patients with nephrotic syndrome

作　　者：刘旭[1] 张启东[1] 姜群[1] 郭王[1] 王刚[1] 刁宗礼[1] 刘文虎[1] 

机构地区：[1]首都医科大学附属北京友谊医院肾内科首都医科大学肾病学系,北京100050

出　　处：《临床和实验医学杂志》2017年第18期1783-1786,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金资助项目(编号:81570660);北京市科技计划课题项目(编号:D131100004713003)

摘　　要：目的探讨肾病综合征患者年龄、性别、病理/病因构成的时间变化。方法收集2008~2011年和2012~2015年两个时间段收治的肾病综合征患者的资料,进行回顾性分析,比较患者的年龄、性别、肾脏病理诊断情况,进一步分别比较各年龄段患者前后两个时间段的肾脏病理诊断情况,并进行统计学分析。结果共记录肾病综合征患者1 077例,平均年龄45.6±16.0岁,男性56.2%。对比两时间段,青年患者比率由42.0%下降至31.2%,老年患者比率由8.7%上升至14.2%。膜性肾病构成比由43.6%大幅上升至62.2%,系膜增生性肾小球肾炎构成比由23.9%下降至12.8%,轻微病变性肾小球肾炎构成比由21.8%下降至16.8%,狼疮性肾炎比率亦有所提高。各年龄段的组内比较,在青年患者组中,系膜增生性肾小球肾炎的比率有所下降,膜性肾病与狼疮性肾炎的比率有所上升;中年患者组中,系膜增生性肾小球肾炎比率由16.5%下降至7.9%,膜性肾病比率由54.3%大幅上升至70.8%;在老年患者组中,同样观察到膜性肾病比率由57.6%大幅升高至75.8%。结论近年来肾病综合征患者的病理/病因构成正在发生改变,膜性肾病发病率升高应引起重视。Objective To explore the changes in age,sex,pathological features/etiology of patients with nephrotic syndrome. Methods The clinical data of patients with nephrotic syndrome during 2008 to 2011 and 2012 to 2015 two periods of time were retrospectively analyzed.The age range,sex and pathological diagnosis were compared. Furthermore,the renal pathological diagnosis of patients in these 2 groups with different age groups were compared respectively. Statistical software had been applied in analysis. Results A total of 1077 patients with nephrotic syndrome were recorded. Their average age was 45. 6 ± 16. 0 years old,and males occupied 56. 2%. In compariso with these two periods,the proportion of young patients had been decreased from 42% to 31. 2%,and the proportion of elderly patients increased from 8. 7% to 14. 2%. The composition ratio of membranous nephropathy was sharply increased from 43. 6% to 62. 2%,the ratio of mesangial proliferative glomerulonephritis was decreased from 23. 9% to 12. 8%,minimally changed glomerulonephritis was decreased from 21. 8% to 16. 8%,and ratio of lupus nephritis was also increased. In comparison with each age group,the proportion of mesangial proliferative glomerulonephritis in young patients group was declined,the ratios of membranous nephropathy and lupus nephritis were increased. In middle-aged patients group,the proportion of mesangial proliferative glomerulonephritis was dropped from 16. 5% to 7. 9%,the proportion of membranous nephropathy had been sharply increased from54. 3% to 70. 8%; and the portion of membranous nephropathy in elderly patients was significantly increased from 57. 6% to 75. 8%. Conclusion In recent years,the pathogenesis of nephrotic syndrome had been changed,and more attention should be paid to the increase in incidence of membranous nephropathy.

关 键 词：肾病综合征 肾脏病理 膜性肾病 

分 类 号：R692[医药卫生—泌尿科学]