高海拔地区成人原发性肾病综合征的病理类型及疗效分析

PATHOLOGICAL AND THERAPEUTIC ANALYSIS IN ADULTS WITH PRIMARY NEPHROPATHY AT 1 885m ALTITUDE

目的：探索海拔在１ ８８５ｍ 的高海拔地区４２例经皮肾活检明确诊断的成人原发性肾病综合征的病理类型与疗效的关系。方法：在Ｂ超引导及Ｘ线静脉肾盂造影电视荧屏下定位于肾下极，采用Ｔｒｕ－ ｃｕｔ肾活检针穿刺，组织分送光镜（包括特染）、免疫荧光镜及电镜检查，分析病理与疗效的关系。结果：成人原发肾病综合征病理类型复杂，系膜增殖性肾炎为最常见的病理类型，其次为ＩｇＡ肾病、ＩｇＭ 肾病、膜增殖性肾炎、微小病变、膜性肾病、局灶性肾小球硬化、毛细血管内增殖性肾炎及新月体肾炎等类型。病理类型与糖皮质激素及免疫抑制剂疗效关系密切。结论：对成人原发肾病综合征应及时行肾活检，明确病理类型，制定因人而异的治疗方案。

In order to observe the relationship between primary nephropathy syndrome(PNS)and its treatment in adults at 1 885m altitude.Methods:42 subjects(men 28,women14),age 15～51yr old,were symptomatic with albuminuria,hypoalnumineria,edema.The biopsy of kidney was performed by renal probes under monitoring of ultrasound and X ray and examined by microscopy.Results:The most common pathological change(type)in PNS was mesangial proliferarive glomerulonephritis,secandly,IgA nephropathy,IgM nephropathy,membranous proliferative glomerulonephritis and others in profer order.Therapeutic efficiency of the PNS with corticosteroid and immunosuppression drug was closely correlated with the pathological Types (changes)in patients with PNS.Conclusion:This research has suggested that biopsy of kideny is an useful way to determine therapeutic plan of PNS on ground of different pathological dignosis in adults with PNS.$$$$