移植肾肾病复发和新发患者的临床病理分析

The Analyses of Patients with Recurrent Glomerulonephritis and De Novo Glomerulonephritis Posttransplantation

目的:探讨肾移植术后肾病复发和新发患者的临床及病理特点。方法:选取南京军区福州总院行移植肾活检的患者111例,其中A组为移植肾肾病复发和新发51例;B组为慢性移植物肾病60例;C组为与A组患者接受同一供肾38例。观察患者术前一般状况、术后穿刺前1周的检验结果及移植肾1、3、5年的存活情况并分析结果。结果:①A组肾病类型及例数:IgAN 15例,FSGS 10例,MPGN 9例,MsPGN 9例,MN 6例,SLE-LN2例。②穿刺前1周SCr、BUN及蛋白尿:A组明显大于C组。③A组移植肾5年存活率明显低于C组,三组移植肾1年、3年存活率无明显差异。结论:①复发和新发肾病以IgAN、FSGS、MPGN较为常见;②肾病复发和新发患者在肾功能异常时,肾功能及蛋白尿均较同一供肾组严重;③复发和新发肾病对移植肾短期存活无明显影响,但可降低其长期存活率。

Objective：To investigate the clinicopathologic manifestations of the patients with recurrent glomer-ulonephritis posttransplantation（RGP） and De Novo glomerulonephritis posttransplantation（DNGP）. Methods：To select 111 cases of the patients who accepted the kidney biopsy from 2004 to 2009 in the Fuzhou General Hospital, 5i cases of the patients were diagnosed with RGP and DNGP （group A）. 60 cases of patients were diagnosed with chronic allograft nephropathy （CAN） （group B）,at the same time,to select 38 cases of the patients who accepted renal from the same donor （group c） with group A ; the data of patients＇ age, gender, graft survival, Scr, BUN and Urinary protein were collected. Results：The Pathological types of the group A included 15 cases of IgAN, 10 cases of FSGS,9 cases of MPGN,9 cases of MsPGN,6 cases of MNand 2 cases of SI.E-LN;The group A was significantly greater than group C in SCr,BUN and Urinary protein;The graft survival ratio of group A was significantly lower than group C 5 years later. Conclusions： ①The common pathological types of the patients with RGP and DNGP is IgAN, FSGS and MPGN; ②the levels of the Scr,BUN and the urine protein from the patients with RGP and DNGP are higher than the patients who accepted the same donor＇s kidney with group A; ③the patients with RGP and DNGP have a worse long term survival.