广西桂北地区单中心1703例肾活检患者的病理分析及疾病谱变化

Pathological analysis and disease spectrum changes of renal biopsy at a single center in northern Guangxi:a report of 1703 cases

目的分析2005至2019年桂林医学院附属医院肾活检患者病理类型的分布特点及疾病谱的变迁。方法收集桂林医学院附属医院2005年1月至2019年12月共计1703例肾活检患者的临床病理资料,对肾脏疾病的临床病理特征进行回顾性分析。结果研究共纳入1703例肾穿刺活检病例,男女比例为1∶1.03,年龄(39.04±15.04)岁。病理类型组成为原发性肾小球肾炎(81.27%),继发性肾小球肾炎(17.91%),肾小管间质疾病(0.82%)。原发性肾小球肾炎最常见的病理类型是IgA肾病(29.93%)和膜性肾病(28.92%),膜性肾病占比从2005至2007年的4.35%上升到2017至2019年的39.27%,呈明显上升趋势。在继发性肾小球肾炎中,狼疮肾炎(40.20%)最为常见,其次是乙型肝炎病毒相关性肾炎(26.47%)、过敏性紫癜性肾炎(12.42%)、糖尿病肾脏疾病(6.54%)。结论原发性肾小球肾炎仍然是肾活检患者最主要的病理类型,IgA肾病和狼疮肾炎分别是最常见的原发性和继发性肾小球肾炎,膜性肾病有逐年增长趋势。

Objective To explore the distribution characteristics and disease spectrum changes of pathological types in patients with renal puncture biopsy.Methods From January,2005 to December,2019,clinicopathological data were retrospectively reviewed for 1703 renal biopsy patients.Results The ratio of male-to-female was 1∶1.03 and the average age(39.04±15.04)years.The pathological types were primary glomerulonephritis(81.27%),secondary glomerulonephritis(17.91%)and tubular interstitial nephropathy(0.82%).The most common pathological types of primary glomerulonephritis were IgA nephropathy(29.93%)and membranous nephropathy(28.92%).Membrane nephropathy revealed a rising trend from 4.35%in 2005-2007 to 39.27%in 2017-2019.Lupus nephritis(40.20%)was the most common secondary glomerulonephritis,followed by hepatitis B virus-associated glomerulonephritis(26.47%),Henoch-Schonlein purpura glomerulonephritis(12.42%)and diabetic kidney disease(6.54%).Conclusions Primary glomerulonephritis remains the predominant pathologic types in renal biopsy patients.IgA nephropathy and lupus nephritis are the most common primary glomerulonephritis and secondary glomerulonephritis.Membrane nephropathy has a yearly rising trend.