临床诊断为原发肾病综合征的病理研究

Clinical and pathological analysis on adult nephritic syndrome

目的:分析临床诊断为原发肾病综合征(PNS)患者的病理类型及其与临床表现之间的联系。方法:对42例临床诊断为PNS患者在彩超引导下,应用自动肾活检枪做经皮肾活检术,标本行光镜、免疫病理及电镜检查,并进行病理分型。结果:患者行肾活检时平均年龄为(32.5±15.3)岁;常见的病理类型为膜性肾病(占38.1%)、IgA肾病(占42.6%)、系膜增生性肾小球肾炎(占9.5%)、IgM肾病(占4.8%)及微小病变肾炎(占4.8%),通过肾活检纠正4例临床诊断。结论:本地区PNS患者多见于青壮年,其中IgA肾病、膜性肾病为最常见的病理类型。肾活检病理对肾病综合征的诊断、治疗及预后评估有重要意义。

Objective： To investigate the relationship between renal pathological category and clinical features by analyzing the clinic pathological date in 42 adult nephritic syndromes having underwent renal biopsy. Methods： Renal biopsy were done for 42 adult nephrotiesyndrome disease patients,light microscopy,immune fluorescence and electron microscopy were used by pathologists and nephrologists. Results： The average age at renal biopsy was （33.1± 14.8） years old patients with renal diseases, in these NS patients, the most frequent pathologic type were membranous nephropathy 38. 1%, IgA nephropathy 42. 6 %, mesangioproliferative glomerulonephritis 9.5%, IgM nephropathy 4.8 %. M nephropathy 4.8% through renal biopsy, right diagnose of 4 patients. Conclusion： In our area, adult Nephritic syndrome were observed often in young people. The incidence in male was higher than that in female. The major pathological categories of the adult Nephritic Syndrome are membranous nephropathy and lgA nephropathy.