308例肾活检病例的临床与病理分析

Clinicopathological Analysis of 308 cases Renal Biopsy

目的研究临床表现与肾脏病理的关系,明确肾活检的临床价值,提高慢性肾脏病的诊治水平。方法回顾性分析308例肾活检病例的病理类型与临床类型、尿检的关系。结果原发性肾小球疾病(PGN)表现为无症状尿检异常(AUA)、肾炎综合征(NiS)、肾病综合征(NS)、急性肾衰竭(ARF)、慢性肾衰竭(CRF)的比例分别是18.8%、25.2%、42.8%、7.2%、6.0%,而继发性肾小球疾病(SGN)分别是3.4%、44.8%、25.9%、6.9%、19.0%,PGN与SGN在表现为AUA、NiS、NS、CRF的差异有统计学意义(P<0.05),在表现为ARF差异无统计学意义(P>0.05)。PGN表现为单纯血尿、少量蛋白尿、中量蛋白尿、大量蛋白尿的比例分别为5.6%、27.2%、29.2%、38.0%,而SGN分别是3.4%、20.7%、41.4%、34.5%,PGN与SGN在血尿、蛋白尿差异无统计学意义(P>0.05)。结论临床方面PGN以NS最常见,SGN以NiS最常见,尿检方面PGN中以大量蛋白尿最常见,SGN中以中量蛋白尿最常见。

Objective To investigate the relationship between clinical manifestation and pathology, and clarify the clinical value of renal biopsy, in order to improve the diagnosis and treatment of chronic kidney disease. Methods 308 cases with renal biopsy were analyzed retrospectively, in cluding the relationship between pathological type and clinical type, hematuria, proteinuria. Results Primary glomerulonephritis（PGN）performanced with asymptomatic urinary ahnormalities（AUA）, nephritic syndrome（NiS）, nephrotic syndrome（NS）, acute renal failure（ARF） and chronic renal failure （CRF）were 18.8%, 25.2%, 42.8%, 7.2% and 6.0%. The performance in secondary glomerulonephritis（SGN）was 3.4%, 44.8%, 25.9%, 6.9% and 19.0%. The different performance between PGN and SGN in AUA, NIS, NS and CRF was statistically significant（P〈0.05）, yet in ARF was insignificant（P〉0.05）. PGN performanced with simple hematuria, a small amount of proteinuria, moderate proteinuria and heave proteinuria were 5.6%, 27.2%, 29.2% and 38.0%. The performance in SGN was 3.4%, 20.7%, 41.4% and 34.5%. There was no significant difference（P〉0.05） between PGN and SGN in hematuria and proteinuria. Conclusions NS is the most common type in PGN, and NIS is most popular for SGN. The heave proteinuria is the most common type in PGN, and moderate proteinuria is the most common type in SGN.