老年肾脏病患者病理与临床特点分析

Analysis of Pathological Findings and Clinical Manifestations in Elderly Patients with Renal Disease

目的分析老年肾脏病患者病理与临床特点,为老年肾脏病患者的诊治提供参考依据。方法回顾性分析从2015年2月1日-2019年2月15日医院收治的老年肾脏病患者250例作为研究对象,对所有患者均进行肾穿刺活检病理实验诊断,分析临床特点、原发性肾小球疾病和继发性肾脏病病理类型分布情况。结果临床特点大量蛋白尿、血压异常升高、单纯尿检异常、高度水肿肉眼血尿,人数占比分别为40.00%、30.80%、10.00%、10.00%、4.80%。病理类型多见为膜性肾病、局灶-节段性病变以及系膜增生性肾炎等,而硬化性肾小球肾炎、系膜毛细血管性肾炎以及新月体性肾小球肾炎等较为少见。继发性肾脏病病理类型多见肾淀粉样变性、狼疮性肾炎、ANCA相关性血管炎等,又以多动脉炎、血栓微血管病、小管-间质病变等较为少见。结论老年肾脏病患者临床特点常见大量蛋白尿、血压异常升高,病理类型中以膜性肾病、局灶-节段性病变、系膜增生性肾炎、肾淀粉样变性、狼疮性肾炎、ANCA相关性血管炎等较为多见。

Objective To analyze the pathological and clinical characteristics of elderly patients with kidney disease,to provide reference for the diagnosis and treatment of elderly patients with kidney disease.Methods A retrospective analysis was performed on 250 elderly patients with renal disease admitted to the hospital from February 1,2015 to February 15,2019,all of whom were diagnosed by renal biopsy pathological experiment,and the clinical characteristics,primary glomerular disease and pathological type distribution of secondary renal disease were analyzed.Results The proportions of elderly patients with renal disease were 40.00%,30.80%,10.00%,10.00%and 4.80%,respectively,for massive proteinuria,abnormally elevated blood pressure,simple abnormal urinalysis,high edema,and gross hematuria.The pathological types of elderly patients with renal disease are mostly membranous nephropathy,focal segmental disease and mesangial proliferative nephritis,while sclerosing glomerulonephritis,mesangial capillary nephritis and crescentic glomerulonephritis are relatively rare.The pathological types of secondary renal disease in elderly patients with renal disease are mostly renal amyloidosis,lupus nephritis,ancA-related vasculitis,etc.,while polyarteritis,thrombomicroangiopathy,tubulointerstitial lesions,etc.,are relatively rare.Conclusion The clinical characteristics of elderly patients with renal disease include abnormally elevated blood pressure and large amount of proteinuria.Among the pathological types,membranous nephropathy,focal segmental disease,mesangial proliferative nephritis,renal amyloidosis,lupus nephritis,ancA-related vasculitis are more common.