肾小球源性血尿伴/不伴少量蛋白尿青年患者病理分析

Pathological features in young patients with glomerular hematuria(with or without a small amount of proteinuria)

目的探讨肾小球源性血尿伴/不伴少量蛋白尿青年患者病理特点。方法选取2010年1月至2012年5月于我院行肾脏穿刺活检临床表现为肾小球源性血尿伴/不伴少量蛋白尿的84例青年患者,对其病理进行分析。对肾活检标本均行光镜、免疫荧光检查,部分标本行电镜检查。结果 84例患者病理如下:15例系膜增生性肾小球肾炎,2例肾小球轻微病变,10例局灶节段性肾小球硬化,6例IgM肾病,1例薄基底膜肾病,50例IgA肾病。34例非IgA肾病病理中无1例出现新月体,50例IgA肾病病理中有5例出现细胞性新月体或纤维素样坏死,5例出现纤维细胞性新月体。结论对于肾小球源性血尿伴/不伴少量蛋白尿的青年患者进行肾脏穿刺活检是非常必要的,对明确其诊断、指导治疗、判断预后有重要的意义。

Objective To explore pathological features in young patients with glomerular hematuria （ with or without a small amount of proteinuria）. Methods From Janumy 2010 to May 2012 in our hospital, we selected 84 cases of young patients who received renal biopsy, with glomerular hematuria （with or without a small amount of proteinuria ）. All renal biopsy specimens were performed with Light microscopy and Immunofluorescence; parts of them were performed Electron microscopy. Results 84 cases of patients with pathological features were as follows. 15 cases were mesangial proliferative glomerulonephritis, 2 cases of glomerular mild disease, 10 patients with focal segmental glomerulosclerosis, 6 cases of IgM nephropathy, 1 case of Thin Basement Membrane nephropathy （ TBMN）, and 50 patients with IgA nephropathy. No patient in the 34 patients with non - IgA nephropathy had pathological crescents, five cases of 50 patients with IgA nephropathy had pathological cellular crescents or fibrinoid necrosis and five cases had fibrous cellular crescents. Conclusions Glomerular hematuria with or without a small amount of proteinuria in young patients, renal biopsy is necessary, and important for a clear diagnosis, treatment and prognosis.