肾小球疾病116例临床与病理分析

Clinical and pathological analysis on 116 cases with glomerular disease

目的：探讨肾小球疾病临床与病理特点。方法回顾性分析2010年1月～2013年6月在我院收治的成人肾小球疾病116例患者的临床病例资料，所有患者均经肾活检确诊为肾小球疾病，分析其肾脏病理类型，以及病理与临床表现的关系。结果116例成人肾小球疾病患者中84例患者为原发性肾小球疾病，占72.4%；32例患者为继发性肾小球疾病，占27.6%。其中IgA肾病是原发性肾小球肾炎的主要病理类型，占39.8%。对于肾病综合征、肾炎综合征的患者，不伴有肾小管间质损害的患者与伴有肾小管间质损害的患者相比，两组间尿白蛋白，血肌酐、血尿酸之间的差异具有统计学意义（P＜0.05）。结论肾小球疾病中以原发性肾小球肾炎最为常见，其中IgA肾病是原发性肾小球肾炎最常见的病理类型；而狼疮性肾炎是成人继发性肾小球肾炎最常见的病理类型。不同的肾小球疾病病理类型可有不同的临床表现，尿白蛋白、血肌酐、血尿酸在肾小球疾病的肾小管间质损害中起着一定作用。

Objective To investigate and analyze the clinical and pathological features of glomerular disease. Methods The clinical data of 116 cases with adult glomerular disease collected in our hospital during January 2010 to June 2013 were retrospectively analyzed. All patients were diagnosed glomerular disease by renal biopsy. The type of renal pathology and the relationship between pathology and clinical manifestations were analyzed. Results In 116 cases with adult glomerular disease,there were 84 patients with primary glomerular disease that accounted for 72.4%,and 32 patients with secondary glomerular disease that accounted for 27.6%. Of which IgA nephropathy was a major pathological type of primary glomerulonephritis and accounted for 39.8%. For the patients with nephrotic syndrome and nephritic syndrome,the differences were statistically significant in urinary albumin,serum creatinine,blood uric acid between the patients with and without tubulointerstitial damage（P 〈 0.05）. Conclusion Primary glomerulonephritis is most common in glomerular disease, of which IgA nephropathy is most common pathological type of primary glomerulonephritis; while lupus nephritis is most common pathological type of adults secondary glomerulonephritis. Different pathology types of glomerular disease may have different clinical manifestations.Urinary albumin, serum creatinine, blood uric acid play a role in the tubulointerstitial damage of glomerular disease.