364例肾活检病理资料分析及中医证候相关性研究  

Analysis of 364 Renal Biopsy and the Correlation Study of TCM Syndromes

作　　者：王娅辉 周静威[2] 刘忠杰[2] 孙鲁英[2] 刘玉宁[2] 王耀献[2] WANG Yahui;ZHOU Jingwei;LIU Zhongjie(Bering University of Chinese Medicine Dongzhimen Hospital, Beijing （100700)

机构地区：[1]北京中医药大学东直门医院,硕士研究生北京100700 [2]北京中医药大学东直门医院肾病科,北京100700

出　　处：《中国中西医结合肾病杂志》2018年第3期208-212,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家科技支撑计划项目(No.2011BAI10B01)

摘　　要：目的:了解我院肾病科13年肾穿刺活检患者的临床诊断、病理类型及与中医证候的相关性,分析各类肾脏疾病的构成比例及变化趋势。方法:回顾性分析北京中医药大学东直门医院肾病科2004年01月~2016年12月364例因肾脏疾病而行肾穿刺活检者的性别、年龄、临床诊断、病理类型及中医证候。结果:原发性肾小球疾病(PGD)占75.3%,继发性肾小球疾病(SGD)占20.3%。PGD中以Ig A肾病(Ig AN)、膜性肾病(MN)和肾小球微小病变(MCD)所占比例较高,分别为38.7%、32.8%、12.4%。SGD中狼疮性肾炎(LN)(29.7%)和乙肝病毒相关性肾炎(HBVGN)(20.3%)最常见。在2004年至2010年的病理资料中,Ig AN占PGD的50.0%,MN占18.0%;而在2011年至2016年的资料中,MN成为最常见的PGD(占41.4%),其次为Ig AN(32.2%)。PGD和SGD的中医证候均以本虚标实证为主,分别占72.6%、78.4%,本虚证以脾肾气虚、气阴两虚证为主,标实证以湿热、水湿证为主。结论:原发性肾小球疾病仍是肾穿刺活检患者中最为常见的肾脏疾病,近年来Ig AN呈减少趋势,而MN的患病率则不断上升;继发性肾小球疾病中狼疮性肾炎仍是首要原因。中医证候方面,PGD和SGD中均以本虚标实证为主,其中脾肾气虚证、湿热证最为多见。Objective： To survey the clinical diagnoses and pathological types,and their correlation to TCM syndromes in the patients with renal biopsy in our hospital for 13 years,analyse the composing characteristics and changing tendency of renal diseases. Methods： From January 2004 to December 2016,histological diagnosis of renal disease was made in 364 patients in Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine. Their demographic data,clinical and pathological data were analyzed retrospectively. Results： Primary glomerular diseases（ PGD） accounted for 75. 3% of the total renal patients biopsied,and secondary glomerular diseases（ SGD） 20. 3%. In PGD cases Ig A nephropathy（ Ig AN）,membranousnephropathy（ MN） and minimal change disease（ MCD） accounted for 38. 7%,32. 8% and 12. 4% respectively. The most frequent types of SGN were lupus nephritis（ LN）（ 29. 7%） and HBV-related glomerulonephritis（ HBVGN）（ 20. 3%）. Ig AN was the most frequent pathologic type（ 50. 0%） of PGD in the data from 2004 to 2010,followed by MN（ 18. 0%）. In the data from 2011 to 2016,MN became the most frequent type（ 41. 4%）,followed by Ig AN（ 32. 2%）. The root deficiency and incidental excess syndrome had a highest occurrence both in PGD and SGD cases（ 72. 6% and 78. 4% respectively）. The spleen and kidney Qi deficiency syndrome and Qi and yin deficiency syndrome were the most common syndromesin root deficiency syndromes,while the damp-heat syndrome and water-damp syndrome in incidental excess syndromes were the most common. Conclusion： PGD is the most common renal disease occurred in patients with renal biopsy. Ig AN decreased significantly while MN increased In recent years. LN is the most frequent type of SGD. The root deficiency and incidental excess syndrome had a highest occurrence both in PGD and SGD cases. The spleen and kidney Qi deficiency syndrome and damp-heat syndrome were the most frequent syndromes.

关 键 词：肾活检 临床诊断 病理类型 中医证候 

分 类 号：R277.5[医药卫生—中医学]