妊娠时肾脏损害临床和肾组织病理变化的分析研究

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５２例妊娠致肾脏损害住院病人进行了临床和肾活检病理的分析研究。结果：５２例终止妊娠 ３个月后仍有蛋白尿，合并肾功能不全者 ２８例（５３．８５％），肾活检免疫病理示ＩｇＧ ３４例、ＩｇＡ ３８例、ＩｇＭ ２８例及Ｃ３４０例肾小球血管袢及系膜区沉积；病理表现系膜增生性肾炎３４例、膜增生性肾炎１０例、局灶节段性肾小球硬化６例、膜性肾病２例，５２例中合并小球硬化者３０例（５７．６９％）；胎儿死亡４０例（７５．４７％）。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，积极诊治该类病人是临床不可忽视的问题。

Objective: To investigate the clinical and pathological features of pregnancy-associated renal injury. Methods :52 inhospital pregnancy-associated renal injured patients were given clinical study and pathological analysis of renal biopsied tissue. Results:52 patients showed persistent proteinuria after pregnansy stopped three months. 28 of them were re-aldeficient patients. Jmmunofluroscent of renal biopsied tissue showed in 34 patients IgG, 38 patients IgA, 28 patients IgM and 40 patients C3 .deposited in glomerular capillary loop and mesangial area. In these 52 patients, 34 were mesangialpro-liferative glomerulonephritis, 10 were membranoproliferative glomerulonephritis,6 were focal segmental gloinerular sclemsis,2 were meinbranous nephropathy, 30 of them complicated with glomerular sclerosis(57. 69%), 40 fetus died(75. 47%). 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.