56例蛋白尿患者临床与肾脏病理分析

A clinical and pathological study on 56 cases with proteinuria

目的:了解蛋白尿患者肾脏病理特点,为治疗及判断预后提供依据。方法:56例蛋白尿住院患者,在B超引导下行肾活检术,进行光镜、免疫荧光及电镜检查,对病理及临床资料进行分析。结果:原发性肾小球病占82.14%,继发性肾小球病占17.86%,无小管间质性病变。原发性肾小球病中,轻微病变发病率最高15例(32.61%),继发性肾小球病中以狼疮性肾炎(LN)最多,为7例(70.00%)。结论:原发性肾小球病仍为常见的肾小球疾病,其中以肾小球轻微病变最为常见,IgA肾病位居第二。继发性肾小球病中以狼疮性肾炎(LN)多见,其他少见的肾脏病如肾淀粉样变等也有检出。

Objective：to understand the pathological characteristics of the patients with proteinuria, and provide the basis for treatment and prognosis. Methods：Fifty-six proteinuria patients,with renal biopsy guided by B ultrasound,were studied by light microscopy,immunofluorescence and electron microscopy. The patients＇ pathological and inical data were analyzed. Results：Primary glomerulopathy accounted for 82.14~ ,and secondary glomerulopathy accounted for 17.86%. None of renal tubulointerstitial damage was observed. Glomerular minor lesion had the highest incidence of primary glomerulopathy（15 cases,32.61M）. Lupus nephritis（LN） had the highest incidence of secondary glomerulopathy （7 cases, 70. 00%）. Conclusion： Primary glomerulopathy is still common glomerular disease,while glomerular minor lesion is the commonest, and IgA nephropathy is the second. Lupus nephritis（LN） is the most common disease of secondary glomerulopathy. Other rare renal diseases such as renal amyloidosis were observed.