53例体检发现蛋白尿和(或)血尿患者临床病理分析

A Clinicopathological Analysis of 53 Proteinuria and/or Hematuria On Routine Examination

目的 :了解体检发现蛋白尿和 (或 )血尿患者的肾脏临床和病理情况。方法 :回顾性病例分析。结果 :5 3例患者中 ,有蛋白尿者 48例 (90 .6 % ) ,其中单纯蛋白尿者占 2 5 % ,2 4h尿蛋白定量 >1.5 g者占 14.6 % ;有血尿者 41例 (77.4% ) ,其中单纯血尿者占 12 .2 % ,红细胞形态异常≥ 70 %者占 5 1.2 % ;同时有蛋白尿和血尿者 36例 (6 7.9% ) ;伴高血压者 2 1例 (39.6 % ) ;内生肌酐清除率 <80ml/min者 14例 (2 6 .4% )。病理类型多样 ,其中 31例 (5 8.5 % )为IgA肾病 ;部分病例病理表现严重 ,有明显活动性病变者占 2 2 .6 % ,经治疗大多肾功能有显著改善。结论 :在人群中开展尿常规普查 ,能早期筛选出可疑肾脏疾病患者 。

Objective: To study the renal clinicopathology of the patients who were found proteinuria and/or hematuria on routine examination. Methods: Retrospective case series. Results: Among 53 patients, 48 (90.6%) were found proteinuria, 25% of them were isolated proteinuria, 14.6% with urinary protein exeretion over 1.5g/24h; 41 (77.4%) were found hematuria, 12.2% of them were isolated hematuria, 51.2% with dysmorphic red cells≥70%; 36 (67.9%) were simultaneously found proteinuria and hematuria; 21 (39.6%) were found hypertension; 14 (26.4%) were found Ccr<80ml/min. Pathologic types were diverse, 31(58.5%) were found IgA nephropathy; some with severe pathologic change, 12(22.6%) of them were found significantly active histology, renal function often can be markedly improved by treatment. Conclusion: Routine urine analysis in population is helpful for screening of early patients with renal disease and the prognosis can be improved.