492例原发性肾脏疾病患者病理及临床表现特征的流行病学分析

Epidemiological analysis of pathologic and clinical manifestation among 492 cases with primary glome rulor disease

目的 了解原发性肾脏疾病患者病理特征、临床表现及其病理构成谱的演变趋势。方法 回顾性分析安徽医科大学第一附属医院 1 997年 1月～ 2 0 0 2年 1 2月 4 92例因原发性肾脏疾病行经皮肾活检患者的性别、年龄、病理类型及临床表现。结果 本组原发性肾脏疾病患者以男性为主 (5 9.1 % ) ,平均年龄为 (2 8.2 4± 9.6 8)a ;2 0～ 39a为高发年龄段。除MsP外 ,病理类型仍以IgAN型为高 (1 9.9% )。FSGS检出率有增加趋势 ,而MN有下降趋势 (P =0 .0 0 0 0 )。病程以EnPGN最短 ,FSGS最长。临床表现以肾病综合征为主 (2 7.4 4 % ) ;各种临床表现的患者其病理类型多样。两组肉眼血尿患者最常见的病理类型均为IgAN。MN、MPGN、MCD患者体内HBsAg的检出率高。结论 原发性肾脏疾病以男性青壮年多见 ,其中IgAN多见。各种病理类型的临床表现不一 。

Objective To survey pathologic feature, clinical manifestation and variation of pathology of primary glomerular disease (PGD). Methods From January 1997 to October 2002, retrospective analyses was made in 492 patients with renal disease in First Affiliated Hospital of Anhui Medical University. Results The mean age was (28.24±9.68)a, 59.1% were male. Except for mesangial proliferative lesion (MsP) (42.7%), IgA nephropathy (IgAN) was most frequent pathologic type (19.9%) of PGD. Focal segmental glomerulosclerosis (FSGS) was found increased (P<0.0001) and membranous nephropathy (MN) decreased ( P<0.0001 ). Course of disease of FSGS was the longest, and endocapillary proliferative glomerulonephritis (EnPGN )was the shortest. The pathological classifications related with clinical syndrome were various. Conclusions Male and adolescent were predominent in this group of patients. Similar pathological change may manifest various clinical profile, vice versa.