996例肾活检临床病理分析

Clinicopathological characteristics in 996 cases with renal biopsy

目的 回顾性分析本院肾脏内科近10年肾活检病理类型及疾病谱变化.方法 收集2006年2月至2016年2月期间996例肾活检患者临床病理资料,分析肾脏疾病临床病理特点.结果 996例肾活检患者中,原发性肾小疾病760例,占76.31％,继发性肾小球疾病211例,占21.18％,肾小管间质性疾病22例,占2.21％,遗传性肾病3例,占0.30％.原发性肾小球疾病最常见病理类型为IgA肾病238例,占31.32％,其次为系膜增生性肾炎199例,占26.18％,膜性肾病127例,占16.71％.继发性肾小球疾病最常见为狼疮性肾炎76例,占36.02％,其次为紫癜性肾炎56例,占26.54％,乙肝相关性肾炎24例,占11.37％.原发性肾小球疾病临床表现最常见为肾病综合征446例,占58.68％,其次为慢性肾炎223例,占29.34％,隐匿性肾小球肾炎69例,占9.08％.结论 原发性肾小球疾病是目前临床最常见肾小球疾病,其病理类型以IgA肾病最为常见,近年来膜性肾病所占比例明显增高.继发性肾小球疾病以狼疮性肾炎最为常见,乙肝相关性肾炎所占比例较前增高.

Objectives To retrospectively analyze the pathologic type of renal biopsy and the change of disease spectrum of recent 10 years in our hospital.Methods The clinical data of 996 patients with renal biopsy from February 2006 to February 2016 in our department were collected and analyzed.Results Among the 996 patients,primary glomerular disease （PGD） was 76.31%,secondary glomerular disease （SGD） was 21.18%,renal tubulointerstitial was 2.21% and hereditary kidney disease was 0.30%.Among the PGD,IgA nephropathy was the most common pathological type with 238 cases （31.32%）,followed by mesangial proliferative glomerulonephritis with 199 cases （26.18%）,membranous nephropathy with 127 cases （16.71%）.Among the SGD,lupus nephritis was the most common pathological type with 76 cases （36.02%）,followed by henoch-schonlein purpura nephritis with 56 cases （26.54%） and hepatitis B virus associated glomerulonephritis （HBV-GN） with 24 cases （11.37%）.Among the PGD,nephritic syndrome was the most common clinical manifestation with 446 cases （58.68%）,followed by chronic glomerulonephritis with 223 cases （29.34%） and latent glomerulomephritis with 69 cases （9.08%）.Conclusions PGD is the most frequent glomerular disease in clinic.IgA nephropathy is the most common pathological type in PGD and the proportion of membranous nephropathy increases significantly in recent years.In SGD,Lupus nephritis is the most common pathological type and the proportion of HBV-GN also increases significantly.