隐匿性肾小球肾炎临床病理及预后分析

Clinical pathology of latent glomeruionephrltis and prognosis

目的：探讨隐匿性肾小球肾炎（latent glomerulonephrifis LGN）临床与病理的关系，及危险因素及相关性分析，提高对该病的进一步认识。方法：对30例临床诊断为LGN的患者均行肾活检穿刺术及实验室检查，肾组织行光镜、免疫组化及电镜检查。结果：单纯性血尿6例（20％）；单纯性蛋白尿9例（30％），蛋白尿伴血尿15倒（50％）；IgA肾病18例（60％），增生性肾病6例（21％），轻微性肾病2例（8.1％），局灶节段性肾病1例（4．9％），膜性肾病1例（3．1％）。合计轻度病变23例（75．2％），偏重病变7例（22．5％）。蛋白尿伴血尿组肾病的发生率最高（P〈0．05—0．01）。其病理改变也相对较重。结论：LGN病理类型多样，但以IgAN为主，蛋白尿伴持续镜下血尿与病情严重程度明显相关。

ObjeetiveC latent glomerulonephritis （latent glomerulonephritisLGN） the relationship between clinical and pathological, and risk factors and correlation analysis, to improve awareness of the disease. Methods30 eases of patients diagnosed as LGN puncture biopsy were performed and laboratory tests, renal light microscopy, immunohistochemistry and electron microscopy. ResuhsHematurla in 6 patients （20%） ; simple proteinuria in 9 cases （30%）, preteinuna asso- ciated with hematuria in 15 cases （50%） ; IgA nephropathy 18 cases （60%）, proliferative kidney disease in 6 patients （21%） mild nephropathy in 2 cases （8. 1% ）, focal segmental renal disease in 1 ease （4.9%）, membranous nephropathy 1 （3.1%）. Total 23 patients with mild disease （75.2%）, emphasizing the lesions in 7 eases （22.5 % ）. Proteinuria associated with hematuria group the highest incidence of kidney disease （P 〈 0.05 -0.01 ）, the pathological changes are relatively heavy ; CanclusionLGN variety of pathological types, but mainly IgAN, preteinuria, with persistent microscopic hematuria was associated with disease severity.