168例肾活检的临床病理学观察

Clinicopathological study of 168 consecutive cases using automatic renal biopsy

目的探讨行肾穿刺肾脏病的病理特征、临床表现及其相互关系。方法收集168例行自动肾活检患者的病理及临床资料进行分析。结果患者年龄14～68(34.2±12.2)岁,以女性为主(56.5%)。128例原发性肾脏病的临床表现以慢性肾小球肾炎最常见,占78例(61.4%),其次为肾病综合征46例(36.2%)。原发性肾小球疾病的病理以系膜增生性肾炎为主,占54例(48.6%),其次是局灶节段性肾小球硬化、IgA肾病、膜性肾病、硬化性肾炎、肾小球轻微病变,分别为34例(32.4%)、8例(7.2%)、7例(6.3%)、4例(3.6%)和1例(0.9%)。继发性肾脏病中以狼疮性肾炎多见,占64.1%,其次是过敏性紫癜肾炎占28.2%,乙肝病毒相关肾炎占5.1%,糖尿病肾病占2.6%。肾穿术后肉眼血尿发生率为6.5%,腰痛3%。结论原发性肾小球疾病以系膜增生性肾炎为最常见的病理类型,继发性肾小球疾病主要为狼疮性肾炎。自动肾活检技术安全性高。

Objective To study the pathological features,clinical manifestations and their relationship of kidney disease.Methods The pathology and clinical data of 168 consecutive patients with automatic renal biopsy were analyzed.Results The age was 14～68（34.2±12.2） years old,predominantly female（56.5%）.The most common clinical manifestations of 128 cases with primary renal disease were chronic glomerulonephritis,accout for 78 cases（61.4%）,secondly nephrotic syndrome 54 cases（36.2%）.The pathological distribution of primary glomerular disease was mesangial proliferative glomerulonephritis accout for 54 cases（48.6%）,focal segmental glomerulosclerosis 34 cases（32.4%）,IgA nephropathy 8 cases（7.2%）,membranous nephropathy 7 cases（6.3%）,sclerosing glomerulonephritis 4 cases（3.6%）,minor glomerular lesions 1 case（0.9%）.Lupus nephritis was the most common secondary renal disease,accounting for 64.1%.The rate of gross hematuria after renal biopsy was 6.5%,low back pain was 3%.Conclusion The mesangial proliferative glomerulonephritis is the most common pathological type of primary glomerular diseases.The mainly secondary glomerular disease is lupus nephritis.Automatic renal biopsy technology has high safety.