肾组织活检在移植肾功能损害的诊断与鉴别诊断中的价值

目的 探讨移植肾组织活检在移植肾功能损害的诊断与鉴别诊断中的价值。方法 对158例移植肾组织活检资料进行回顾分析。结果 158例中以急性排斥反应多见，共55例（34．8％），移植肾改变35例（22．2％），临界改变32例（20．2％），慢性排斥反应13例（8．3％），系膜增生性病变13例（8．3％），急性肾小管坏死6例（3．8％），新月体性肾炎、溶血性尿毒综合征和毛细血管内增生性肾炎各1例（0．6％）；血中环孢素A的浓度与急性排斥反应的发生率无明确正相关关系；临床诊断与肾组织活检结果尚存在一些差异。结论 肾组织活检对明确诊断及提高临床诊断的正确率及选择治疗方案有重要价值。

The value of biopsy in diagnosis and differentiate diagnosis of human renal allo graft impairment

Objective　 To investigate the relation between clinical diagnosis and histologic lesion in renal allograft patients who received graft biopsies. Method　158 cases undergoing renal allograft biopsies fro m June 1996 to Dec. 1998 were analyzed retrospectively. Results　Among the 158 cases, acute rejection occurred in 5 5 cases (34.8 %), renal allograft change in 35 cases (22.2 %), borderl ine lesion in 32 cases (20.2 %), chronic rejection in 13 cases (8.3 % ), mesangial proliferative lesion in 13 cases (8.3 %), acute tubular necros is in 6 cases (3.8 %), glomerular crescents formation in 1 case (0.6? %), HUS in 1 case (0.6 %), endocappillary proliferative lesion in 1 case ( 0.6 %). The level of CsA in plasma had no relation with the occurrence of a cute rejection. The difference between clinical and histological diagnosis were encountered in some patients. Conclusions　The renal biops y might be essential for establishing the correct diagnosis of renal allograft d y sfunction and so selecting the appropriate management.