359例肾活检患者病理和临床资料分析

Analysis of Pathological and Clinical Data of 359 Cases Receiving Renal Biopsy

目的分析肾穿刺活检术(简称肾活检)患者的病理分型与临床资料。方法回顾性分析2011年7月至2015年1月359例在弋矶山医院肾穿刺患者的临床资料。结果 359例患者中,原发性肾小球疾病284例,占79.1%;继发性肾小球疾病75例,占20.9%;最普遍的原发性肾小球肾炎病理类型为Ig A肾病(Ig A nephropathy,Ig AN)(35.7%),其次系膜增生性肾小球肾炎(mesangial proliferative glomerulonephritis,Ms PGN)(13.6%),膜性肾病(membranous nephropathy,MN)(11.7%),局灶节段性肾小球硬化(focal segment glomerulosclerosis,FSGS)(9.2%),微小膜病变(minimal change disease,MCD)(7.5%);继发性肾小球肾炎:狼疮肾炎(upus nephritis,LN)(18.1%),紫癜性肾炎(Henoch-Schnlein purpura glomerulonephritis,HSPN)(1.7%)。对于Ig AN的患者,72.3%表现为肾炎综合征(n=68),狼疮肾炎的患者,66.0%(n=31)表现为肾炎综合征。Ms PGN的患者,67.5%表现为慢性肾炎综合征(n=27),对于MCD患者,60.9%(n=14)表现为慢性肾炎综合征。结论由于肾脏疾病的临床表现与病变程度往往不一致,因此肾活检对于肾脏疾病的诊断和治疗方案的制订有着非常重要的意义。

Objective To analyze the pathological and clinical data of patients receiving renal biopsy. Methods The clinical data of 359 cases receiving renal biopsy admitted into Yijishan Hospital from July 2011 to Janurary 2015 were retrospectively analyzed. Results Among the 359 patients, 284 cases with pt4mary glomeru[ar disease accounted for 79. 1% , and 75 cases with secondary glomerular diseases made up 20. 9%. The most common pathological type of primary glomerular nephritis was IgA nephropathy （IgAN） （35.7%）, followed by mesangial proliferative glomerulonephritis （MsPGN） （13.6%）, membranous nephropathy （MN） （11.7%）, focal segmen- tal glomerular sclerosis （FSGS） （9.2%）, and minimal change diseases （MCD） （7.5%）. As for secondary glomerulonephritis, the types included lupus nephritis （LN） （18. 1% ） and Henoch- Schnlein purpura glomerulonephritis （HSPN） （1.7%）. 72. 3% of the patients with IgAN suffered from nephritis syndrome （n =68）, and so did 66. 0% of the patients with LN （n =31 ）. 67. 5% of the pa- tients with MsPGN were attacked by chronic nephritis syndrome （n =27）, and so were 60. 9% of those with MCD （n = 14）. Conclu- sion Due to the inconsistence between the clinical manifestations and the pathological changes degree of kidney diseases, the renal biopsy remains very important in the diagnosis and treatment of kidney disease.