原发性肾小球肾炎病理谱的变化——一项来自单中心的数据  

Changes in pathological spectrum of primary glomerulonephritis——a single center data

作　　者：董慧 张蓓茹[1] 李璐婷 何平[1] 王艳秋[1] 孙广萍[1] Dong Hu, Zhang Beiru, Li Luting, He Ping, Wang Yanqiu, Sun Guangping(Department of Nephrology, Shengjing Hospital Affiliated to China Medical University,Sheyang 110004, China)

机构地区：[1]中国医科大学附属盛京医院肾内科,辽宁沈阳110004

出　　处：《临床荟萃》2018年第7期595-598,602,共5页Clinical Focus

摘　　要：目的分析近年肾穿刺活检患者肾脏病理类型及临床表现,评估原发性肾小球肾炎(PGN)的流行病学特点。方法收集2009年8月至2016年4月中国医科大学附属盛京医院肾内科住院行肾穿刺活检患者的病理资料及穿刺活检时的临床表现,按照肾穿刺时间、性别及年龄进行分组,分析PGN的流行病学特点,以及不同性别、年龄的分布特点。同时观察不同病理类型患者的临床表现,分析两者之间的关系。结果行肾穿刺活检诊断PGN患者1 642例,其中膜性肾病(MN)最多见,共556例(33.86%),以中老年患者为主,男性多见,且其发病率逐年增加。IgA肾病(IgAN)为第二位,有511例(31.12%),且有逐年下降趋势,虽然在青年组仍为主要病理类型,但是在中老年患者中发病率次于MN。不同病理类型患者临床表现有差别,MN患者主要表现为肾病综合征(NS),而IgAN患者主要表现为蛋白尿合并血尿。结论 PGN疾病谱近些年发生改变,流行病学资料的获得将有助于分析其原因,进一步明确肾小球肾炎的可能致病因素。Objective To evaluate the epidemiological characteristics of PGN by analyzing the pathological types and clinical manifestations of patients receiving renal biopsy in recent years.Methods The renal pathological data and clinical manifestation of patients receiving renal biopsy from August 2009 to April 2016 were collected.Patients were grouped according to the time of renal biopsy,gender and age in order to analyze the epidemiological characteristics of PGN.At the same time,the clinical manifestations of different pathological types were observed and the correlation between them were analyzed.Results A total of 1 642 cases diagnosed as PGN by renal biopsy were enrolled in this study.Among them,MN was the most common pathological type,which had 556 cases and accounted for 33.86%.The majority of the patients was the middle-aged and the elderly,and the incidence of the disease was increasing year by year.IgAN was the second pathological type and had 511 cases（31.12%）.Although it was still the main pathological type in the youth group,in middle-aged and elderly patients,its incidence was inferior to MN,presenting a downward trend yearly.The clinical manifestations of patients with different pathological types were different.MN was mainly manifested as NS,while the main manifestation of IgAN was Pro and Hem.Conclusion The disease spectrum of PGN has changed in recent years,and the acquisition of epidemiological data will help to analyze the causes and further clarify the possible pathogenic factors of glomerulonephritis.

关 键 词：肾小球肾炎 病理学 肾小球肾炎 膜性 肾小球肾炎 IGA 

分 类 号：R692.31[医药卫生—泌尿科学]