原发性肾病综合征合并急性肾衰竭临床病理分析

Analysis of the clinical pathology of primary nephrotic syndrome with acute renal failure

目的:对原发性肾病综合征合并急性肾衰竭疾病的临床病理特点进行探讨分析,从而对该类并发症提高防治水平。方法:选择原发性肾病综合征合并急性肾衰竭患者25例,将其作为观察组,同时选择单纯原发性肾病综合征患者25例,将其作为对照组,比较分析这两组的临床表现以及病理特点。结果:观察两组的血压、血浆白蛋白浓度以及血肌酐浓度与血尿素氮浓度,观察组与对照组之间的差异;对两组进行病理分析,观察组中患者发生中、重度系膜增殖性肾小球肾炎的可能性明显高于对照组;观察组中膜增生性肾小球肾炎患者比对照组中多;观察组中骨间质改变患者多于对照组;观察组中患者D-二聚体阳性率多于对照组;观察组中患者的血浆纤维蛋白含量比对照组高。结论:原发性肾病综合征合并急性肾衰竭患者的肾小球病理改变比较严重,大多伴有肾间质改变、高凝状态以及血栓形成,并且其血浆白蛋白的浓度比较低。所以,对于原发性肾病综合征合并急性肾衰竭患者要尽可能早地行肾穿刺活检术,从而使其病理类型更加明确,并依据病理特点确定有效治疗方案,能够使患者预后得到很大程度的改善。

Objective:To discuss and analyze the clinical and pathological features of primary nephrotic syndrome with acute renal failure,in order to raise the level of prevention and treatment of the complications.Methods:To select 25 cases of patients with primary nephrotic syndrome with acute renal failure,as the observation group,while select 25 cases of patients with simple primary nephrotic syndrome,as control group,comparative analysis of clinical manifestation and pathological characteristics of these two groups of patients.Results:To observe blood pressure,plasma albumin concentration,the concentration of serum creatinine and blood urea nitrogen concentration of the two groups patients,there were significant difference between the observation group patients and the control group patientsw.The pathological analysis of two groups of patients,the possibility of medium and heavy mesangial hyperplastic glomerulonephritis in the observation group was higher than that in control group;patients with proliferative glomerulonephritis in the film in the observation group was more than in the control group;patients with bone interstitial change in the observation group was more than in control group;patients with D-dimer positive in the observation group was more than in control group;plasma fibrinogen levels in patients were higher than that of the control group.Conclusion:The glomerular pathology change of primary nephrotic syndrome with acute renal failure patients is more serious,mostly with renal interstitial change,hypercoagulability and thrombosis,and the relatively low concentration of plasma albumin.So,for primary nephrotic syndrome with acute renal failure patients should be as early as possible for renal biopsy,the pathological types more clear,so as to effectively treat the scheme according to the pathological characteristics,can greatly improve the prognosis of the patients.