妊娠致肾脏损害特点临床和肾活检病理的研究

Clinical and Renal Biopsied Pathological Study on Pregnancy Associated Renal Injury

目的 为探讨妊娠致肾脏损害的临床特点及病理特征。方法 对 46例妊娠致肾脏损害住院患者进行了临床和肾活检病理的分析研究。结果 46例终止妊娠 3个月后仍有蛋白尿 ,合并肾功能不全者 2 6例 ( 56 .52 % ) ,肾活检免疫病理示 Ig G32例 ,Ig A36例 ,Ig M2 8例及 C338例肾小球血管袢及系膜区沉积 ;病理表现系膜增生性肾炎 2 8例、膜增生性肾炎 1 0例、局灶节段性肾小球硬化 6例、膜性肾病 2例 ,46例中合并小球硬化者 2 8例 ;胎儿死亡 36例 ( 76 .6 0 % )。结论 妊娠激发了免疫反应导致肾脏病变是肾小球疾病发病机制之一 ,积极诊治该类患者是临床不可忽视的问题。

Objective To investigate the clinical and pathological features of pregnancy associated renal injury.Methods 46 cases of pregnancy associated renal injury were studied with clinical manifestation and pathological characteristic of renal biopsy.Results 46 patients had persistent proteinuria after pregnancy stopped 3 months, in which , 26 were associated renal deficiency.Immunofluroscent of renal biopsied tissue showed that in 32 patients IgG,36 IgA,28 IgM and 38 C3 deposited in glomerular capillary loop and mesangial area.Of 46 patients, 28 were mesangialproliferative glomerulonephritis,10 membranoproliferative glomerulonephritis,6 focal segmental glomerular sclerosis,2 membranous nephropathy; and 28 complicated with glomerular sclerosis,36 fetus died(76.6%).Conclusion Renal injury caused by pregnancy stimulated immunoreaction is one of the pathogenesis of glomerular disease. It is an unneglectful question in clinic to give these patients timely diagnosis and treatment.