江西区域肾脏病病理资料的流行病学分析

Clinical Epidemiology of Renal Diseases in Jiangxi Based on Pathology Data

目的了解江西区域肾脏病的临床表现,病理类型和流行病学特点。方法对1997年5月～2003年12月在我科行肾活检的1602例肾脏病患者的性别、年龄、病理类型及临床表现等进行分析。结果原发性肾小球疾病男性占65.8%,继发性肾小球疾病29.9%。女性占继发性肾小球疾病的70.1%。好发年龄段为15～39岁。其中毛细血管内增生性肾小球肾炎(EnPGN)和紫癜性肾炎(HSPN)好发于<14岁。>49岁者糖尿病肾病(DN)、肾淀粉样变(AN)、微型多动脉炎(MPA)、多发性骨髓瘤肾损害(MultipleMyeloma)多发,其他类型多发于20～39岁之间;临床表现:(1)慢性肾炎综合征(CNS)37.57%;(2)肾病综合征(NS)27.90%;(3)肉眼血尿(GH)12.11%;(4)慢性肾衰(CRF)9.49%;(5)急性肾衰(ARF)5.50%;(6)急进性肾炎(RPGN)3.93%;(7)急性肾炎综合征(ANS)3.50%,CNS最常见为系膜增生性肾炎(MsPGN)24.75%和IgA肾病(IgAN)21.26%。NS最常见为MsPGN29.30%、膜性肾病(MN)12.98%、HSPN12.98%。ARF最常见于急性间质性肾炎(AIN)和急性肾小管坏死(ATN)。CRF最常见于IgAN,肾小球硬化(SCGN)和局灶节段性肾小球硬化(FSGS)。江西省内不同地区患者的病理类型构成比相近无显著性差异(P>0.05)。结论原发性肾小球疾病是导致CRF的主要病因,男性和青壮年多发。继发性肾小球疾病女性多发。

Objective To survey the clinical features, pathology type and epidemiology trait of renal disease in Jiang xi area.Methods The data of 1602 patients including sex,age,pathology type,clinical features were reviewed retrospectively, and all the patients had been examined by renal biopsy in our hospital from May 1997 to December 2003.Results The average age of the patients was 29.6(6~68)years old. Among these cases,59.4% were male(952 cases),and (40.68%) were female(650 cases).In male primary glomerular disease was 65.8% and secondary glomerular disease was 29.9%.In female secondary glomerular disease was 70.1%.A high incidence rate of this group patients occurred at the age from 15 to 39 years old.ENPGN and HSPN were apt to suffer before 14 years old. DN,AN,MPA and Mutiple Myeloma were apt to suffer after 49 years old.The other types were mostly suffered from 19 years old to 39 years old. The followings were the clinical features and its ratio:(1)CNS 37.57%,(2)NS 27.90%,(3)GH (12.11%),(4)CRF 9.49%,(5)ARF 5.50%,(6)RPGN 3.93%,(7)ANS 3.50%.CNS mostly manifest MsPGN(24.75%)and IgAN(21.26%). NS mostly manifest MsPGN(29.30%)and MN((12.98%))and HBVGN (12.98%).ARF mostly manifest AIN and ATN.CRF manifest IgAN,SCGN and FSGS.Conclusion primary glomerular disease was the main cause of CRF,especially in the male and youth.Females are predominant in secondary glomerular disease.The incidence rate of IgAN is lower and the incidence rate of HBVGN is higher than those in the other areas in China (P<(0.01)).