669例肾活检病理分析  

The pathologic entities of renal biopsy

作　　者：施向东[1] 陈士芳[1] 胡小芹[1] 范德墉[1] 

机构地区：[1]浙江省湖州市中心医院肾内科,313000

出　　处：《浙江临床医学》2003年第10期724-725,共2页Zhejiang Clinical Medical Journal

摘　　要：目的 回顾总结本院自1992年1月～2001年12月669例因肾脏疾病行经皮肾活检的病理标本 ,并初步比较了各型的年龄分布。方法 参照WHO(1982年及1995年 )肾小球疾病组织分型方案 ,结合临床、实验室检查结果 ,通过免疫病理及超微结构改变 ,明确病理诊断。结果 本组669例肾脏疾病肾活检的平均年龄 (33.56±8.76) (9～79)岁 ,男女之比0.71 :1。本组原发性肾小球疾病占73.69 % ,继发性肾小球疾病占21.97 % ,遗传性肾脏疾病占0.60 % ,小管间质性疾病占3.14% ,未分类型占0.60 % ,其中急性肾功能衰竭占2.24 %。原发性肾小球疾病中以系膜增殖性肾小球肾炎最多 (31.03 % ) ,其次分别为IgA肾病 (29.41 % ) ;继发性肾脏病中以狼疮性肾炎最多(55.78% ) ,其次是紫癜型肾炎 (21.77 % );绝大多数是在近4～5年检出的。急性肾功能衰竭的病理变化多种多样 ,但仍以急性肾小管坏死多见 ,在急性间质性肾病中与药物相关的也不可忽视。结论 原发性肾小球肾炎仍是最常见的肾小球疾病 ,其中以系膜增殖性肾小球肾炎和IgA肾病最常见 ,继发性肾脏病以狼疮性肾炎多见 ,且有逐年增多的趋势。随着诊断水平的提高 ,少见的肾脏疾病也有零星检出。急性肾功能衰竭的病理变化多样 。Objective To evaluate the pathologic entities of percurtaneous renal biopsy. Method Pathological classifications were made according to the WHO criteria of 1982 for renal pathology or the modified WHO criteria of 1995 by a panel of pathologists and nephrologists in routine-pathological rounds.Results The mean age at renal biopsy was 33.56±8.7(9-79)years in 669 patients with renal diseases with a male to female ratio of 0.71:1 ,primary glomerular disease(PGD)accounted for 73.69% of the total renal patients biopside,secondarry glomerulornephritis (SGN)21.97%,hereditary renal diseases 0.60%,tubular-interstitial diseases 3.14%,and unclassified renal diseases 0.60%.Acute renal failure auount for 2.24% of the total renal patints biospide.The most frequent type of PGD was mesangial moliferativelesion(Mspl)(31.03),followed by IgAN(29.41%),......Lupus nephritis(LN)was the most frequent patholigic type of SGN(55.78%),followed by (Henoch-schonlein purpura glomerulonephritis)(HSPN)(21.77%)......and most of SGN were found by renal biopsy during the late three to four years.The pathologic type of acute renal failure were very much,but the most frequent type of ARF was acute tubular necrosis,the nephritis connected with drug can't be ignore among acute interestitial nephritis. Conclusion PGD was the most common renal disease,of which MSPL and IgAN were the most frequent pathologic type.The most frequent pathologic type of SGDwas LN.Rare renal diseases also were found by renal biopsy with the development of diagnosis standard.The pathologic types of ARF were very much.quite a few of which were related with drug.

关 键 词：肾脏疾病 经皮肾活检 年龄分布 肾小球疾病 遗传性肾脏疾病 小管间质性疾病 

分 类 号：R446.8[医药卫生—诊断学]