老年肾脏病患者行肾活检的临床表现及肾脏组织病理分型  

Clinical manifestations and renal histopathological typing of elderly renal diseases patients receiving renal biopsy

作　　者：田秀娟 王頔 黄晨 TIAN Xiu-Juan;WANG Di;HUANG Chen(Department of Nephrology,the First Affiliated Hospital,Airforce Military University,Xi′an 710032,China)

机构地区：[1]空军军医大学西京医院肾脏内科,西安710032

出　　处：《中华老年多器官疾病杂志》2022年第2期81-85,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金(31970857)。

摘　　要：目的分析老年肾脏病患者的临床表现及肾脏组织病理学分型。方法回顾性分析2016年1月至2020年12月在空军军医大学西京医院进行肾活检的老年肾脏病患者的流行病学特征、临床表现及肾脏组织病理分型。采用SPSS 19.0软件进行数据分析。结果在4386例接受肾脏活检的患者中,共纳入老年肾脏病患者(≥65岁)360例,其中男性231例,女性129例,年龄(70.04±4.59)岁。肾活检最常见的临床表现是肾病综合征,占42.22%(152/360)。肾脏组织病理学仍以原发性肾小球疾病为主,占62.78%(226/360),其中膜性肾病占59.29%(134/226)、IgA肾病占19.91%(45/226)、微小病变占12.39%(28/226);继发性肾小球疾病发生率为31.11%(112/360),其中糖尿病肾病占首位[23.21%(26/112)],其次为抗中性粒细胞胞浆抗体相关性血管炎、淀粉样变性病,均占19.64%(22/112)。结论老年肾脏病患者的临床病理表现复杂多样。对病因不明的老年肾脏病患者,应及早行肾脏病理活检,有助于明确诊断,及早治疗,改善患者预后。Objective To analyze clinical manifestations and renal histopathological typing in the elderly patients with renal diseases.Methods A retrospective study was made of the elderly patients who underwent renal biopsy in Xijing Hospital of Air Force military Medical University from January 2016 to December 2020 in their epidemiological characteristics,clinical manifestations and renal histopathological typing.SPSS statistics 19.0 was used for statistical analysis.Results Among the 4386 patients who underwent renal biopsy,there were 360 elderly renal diseases patients(male 231,female 129).The average age was(70.04±4.59)years.Nephrotic syndrome(42.22%,152/360)was the most common indication of renal biopsy.The most common histopathological diagnosis was still primary glomerular disease(62.78%,226/360),of which membrane nephropathy was the most common(59.29%,134/226),followed by IgA nephropathy(19.91%,45/226)and minimal-change disease(12.39%,28/226).The incidence of secondary glomerular disease was 31.11%(112/360),diabetic nephropathy accounts for the first place(23.21%,26/112),followed by anti-neutrophil cytoplasmic antibody-associated small-vessel vasculitis and amyloidosis,both accounting for 19.64%(22/112).Conclusion The clinicopathological manifestations of elderly patients with renal disease have their own characteristics.For the elderly patients with renal disease of unknown etiology,renal pathological biopsy should be performed as soon as possible,which is helpful to make a clear diagnosis and early treatment and improve the prognosis of the patients.

关 键 词：老年人 慢性肾脏病 肾活检 组织病理 

分 类 号：R692.6[医药卫生—泌尿科学] R592[医药卫生—外科学]