150例肾穿刺活检的病理类型与流行病学特征分析

Analysis of pathological types and epidemiological characteristics of 150 cases of renal biopsy

目的探讨川东北地区150例肾穿刺活检的病理类型与流行病学特征。方法回顾性分析该院2019年1月至2020年12月150例肾穿刺活检患者的临床资料和病理资料,分析其临床特征和病理类型构成。结果150例肾穿刺活检患者中,男女比例为1.00∶1.14,其中男70例,女80例,发病高峰年龄为18~44岁。原发性肾小球疾病(PGN)119例(79.3%),其中IgA肾病(IgAN)51例(42.9%)、膜性肾病(MN)27例(22.7%)、系膜增生性肾小球肾炎(MsPGN)18例(15.1%)、肾小球微小病变(MCD)10例(8.4%)、局灶节段性肾小球硬化(FSGS)7例(5.9%)、膜增生性肾小球肾炎(MPGN)3例(2.5%)、增生硬化性肾小球肾炎(PSGN)2例(1.7%)、新月体肾小球肾炎(CreGN)1例(0.8%);继发性肾小球疾病(SGN)疾病30例(20.0%),其中狼疮性肾炎(LN)8例(26.7%)、糖尿病肾病(DN)6例(20.0%)、过敏性紫癜性肾炎(HSN)5例(16.7%)、肾淀粉样变性(ANP)3例(10.0%)、高血压肾病(HN)3例(10.0%)、乙型肝炎病毒相关性肾炎(HBN)3例(10.0%)、单克隆免疫球蛋白血症肾病(MGRS)1例(3.3%)、ANCA相关性血管炎肾损害1例(3.3%);遗传性肾小球疾病(Aplort综合征)1例(0.7%)。PGN病理分型中IgAN占比最高(42.9%),其次为MN(22.7%)。PGN临床诊断不同,其病理分型也存在差异。SGN中LN发生率最高(26.7%),其次为DN(20.0%)。结论肾小球疾病以PGN最常见,其中IgAN和MN是最多见的病理类型,SGN以LN、DN多见。

Objective To investigate the pathological types and epidemiological characteristics of 150 cases of renal biopsy in Northeast Sichuan.Methods The clinical and pathological data of 150 patients with renal biopsy from January 2019 to December 2020 were analyzed retrospectively.The clinical characteristics and pathological types were analyzed.Results Of the 150 patients with renal biopsy,the male to female ratio was 1.00∶1.14,including 70 males and 80 females,and the peak age of onset was 18 to 44 years old.There were 119 cases of primary glomerular disease(PGN,79.3%),including 51 cases of IgA nephropathy(IgAN,42.9%),27cases of membranous nephropathy(MN,22.7%),18 cases of mesangial proliferative glomerulonephritis(MsPGN,15.1%),ten cases of glomerular micro-pathies(MCD,8.4%),seven cases of focal segmental glomerulosclerosis(FSGS,5.9%),three cases of membranous proliferative glomerulonephritis(MPGN,2.5%),two cases of proliferative sclerosing nephritis(PSGN,1.7%),and one case of crescent glomerulonephritis(CreGN,0.8%).There were 30 cases of secondary glomerular disease(SGN,20.0%),including eight cases of lupus nephritis(LN,26.7%),six cases of diabetic nephropathy(DN,20.0%),five cases of Henoch-Schonlein purpura nephritis(HSN,16.7%),three cases of renal amyloidosis(ANP,10.0%),three cases of hypertensive nephropathy(HN,10.0%),three cases of hepatitis B virus-associated glomerulonephritis(HBN,10.0%),one case of monoclonal immune globulinemia nephropathy(MGRS,3.3%),one case of ANCA associated vasculitis and kidney damage(3.3%),and one case of hereditary glomerular disease(Aplort syndrome,0.7%).Among the pathological types of PGN,IgAN was the highest(42.9%),followed by MN(22.7%).The clinical diagnosis of PGN was different,and its pathological classification was also different.The incidence of LN was the highest in SGN(26.7%),followed by DN(20.0%).Conclusion The results of renal biopsy in the hospital showed that PNG were the most common,among which IgAN and MN were the most common pathological types,and SGN were more frequently seen as LN and DN.