505例大别山地区肾活检资料的流行病学特点和病理分析

目的：了解大别山地区肾脏病理类型和流行病学特点。方法收集本院2004年6月至2013年12月505例肾活检资料进行分析。结果505例患者男女比例1.00∶1.21。原发性肾小球疾病占73.7%;继发性肾脏病占25.5%;肾小管间质疾病占0.8%。临床类型占前3位的是：原发性肾病综合征、慢性肾炎综合征、狼疮性肾炎。原发性肾小球疾病中 IgA 肾病占30.9%;系膜增生性肾小球肾炎占25.8%;膜性肾病占14.5%。原发性肾病综合征中最常见的病理类型是系膜增生性肾小球肾炎,其次膜性肾病和 IgA 肾病。继发性肾脏病中最常见的类型是狼疮性肾炎。结论大别山地区青壮年为肾病高发人群,最常见的病理类型是 IgA 肾病。     

安徽省皖南地区261例肾组织活检临床病理资料分析

目的:了解肾小球疾病临床与病理之间的关系,认识肾活检在肾脏病诊治中的价值。方法:回顾性分析261例肾活检的临床及病理资料。结果:①原发性肾小球疾病190例(占72.8%),继发性肾小球疾病71例(占28.2%)。原发性肾小球疾病以IgA肾病为主(占48.9%)。继发性肾小球疾病以狼疮性肾炎为主(占83.1%)。②临床类型占前2位的依次为慢性肾炎(62.1%)和肾病综合征(23.4%)。慢性肾炎最常见的病理类型依次是IgA肾病(51.9%)、狼疮肾炎(21.6%)和系膜增生性肾炎(9.9%);肾病综合征最常见的病理类型依次是膜性肾病(36.1%)、微小病变性(21.3%)和狼疮肾炎(19.7%)。结论:原发性肾小球疾病是目前最主要的肾小球疾病;慢性肾炎是最常见的临床类型,其病理类型主要是IgA肾病和狼疮性肾炎。肾活检对肾脏病的明确诊断、指导治疗及判断预后均有非常重要的作用。     

昆明地区157例肾脏疾病患者的病理与临床表现

目的 探讨昆明地区肾活检患者的病理类型与临床表现的相互关系.方法 回顾分析2008年1月～2010年1月间因肾脏疾病住院行肾活检的患者的临床病理特点.结果 157例肾脏疾病中,原发性肾小球疾病有133例(84.7%)、小管间质疾病4例(2.5%)、继发性肾脏病20例(12.7%),原发性肾小球疾病中系膜增生性肾炎占41.4%,IgA肾病占18%;继发性肾小球肾炎中狼疮性肾炎占5.1%;小管间质疾病中慢性间质性肾炎占75%.本组患者最常见的临床表现为蛋白尿血尿,各种病理类型与临床表现间有联系.结论 本组资料显示原发性肾小球疾病仍为我国最常见的肾脏疾病,其中以系膜增生性肾炎和IgA肾病最常见;小管间质疾病发病率有增高趋势,继发性肾脏病以狼疮性肾炎最常见,其它特殊肾脏病(如薄基膜肾病)逐年检出增加.     

326例经皮肾活检临床与病理分析

目的:回顾总结本院2010年9月至2012年4月进行肾穿刺活检的标本,分析肾脏疾病经皮肾活检的病理类型构成比例。方法:参照WHO肾小球疾病的组织学分型方案,通过光镜及免疫荧光检测明确病理诊断。结果:326例肾活检病人中,原发性肾小球疾病258例占首位(79.14%),继发性肾小球疾病39例占11.96%,其它占8.90%。原发性肾小球疾病病理类型中最多的是IgA肾病(43.41%),其次为微小病变肾病(25.97%)和膜性肾病(13.18%)。继发性肾小球疾病中狼疮性肾炎占首位(41.03%),其次为紫癜性肾炎(35.89%)。结论:原发性肾小球疾病为常见的肾小球疾病,其中以IgA肾病最为常见;继发性肾小球疾病中以狼疮性肾炎最多见。随着肾活检的广泛开展,其它少见的肾脏疾病也有检出。     

349例肾病患者肾组织活检病理与临床分析

目的了解近年来因肾脏病行经皮肾穿刺活检患者的病理类型构成及其与临床表现的关系。方法收集我院2005年8月至2007年5月之间349例肾病患者肾组织病理活检以及临床资料并进行分析。结果原发性肾小球疾病仍是最常见的肾脏疾病，其中IgA肾病最多见；继发性肾脏疾病以过敏性紫癜性肾炎、狼疮性肾炎和乙型肝炎病毒相关性肾炎最常见。原发性肾病综合征以非IgA系膜增生型肾病最常见，其次为IgA肾病。IgA肾病主要表现为以蛋白尿、血尿为主的肾炎综合征，而非IgA系膜增生型肾病主要表现为肾病综合征。结论本组资料显示原发性肾小球疾病仍是最常见的肾脏疾病，其中以IgA肾病最常见；继发性肾脏病仍以过敏性紫癜性肾炎和狼疮性肾炎最常见；原发性肾病综合征中非IgA系膜增生型肾病最常见。     

158例肾活检病理及临床分析

目的回顾性总结158例肾活检的病理结果,分析其病理类型及临床分类特点。方法总结我院158例肾活检病理资料,分析其病理类型与临床分类特点。结果158例肾活检中原发性肾小球疾病125例(79.11%),继发性肾小球疾病33例(20.89%)。原发性肾小球疾病病理类型最多的是系膜增生型肾炎,第二位是IgA肾病,继发性肾小球疾病以紫癜性肾炎病理类型最多。原发性肾小球疾病临床分布最多的前三位依次是肾病综合征、慢性肾炎、IgA肾病。其中肾病综合征的病理类型主要是系膜增生型和膜性肾病,慢性肾炎的主要病理类型是系膜增生型和肾小球硬化。结论原发性肾小球疾病是最常见的肾小球疾病,肾活检病理类型以系膜增生型肾炎、IgA肾病最多,临床类型则以肾病综合征、慢性肾炎、IgA肾病最为多见。     

山西省265例继发性肾小球肾炎的病理类型及流行病学分析

目的了解山西省继发性肾小球肾炎(SGN)的临床表现,病理类型和流行病学特点。方法回顾性分析我院1993-07~2006-10收治的265例因继发性肾小球肾炎而行肾活检者的性别、年龄、病理类型及临床表现。结果①本组265例肾脏疾病患者行肾活检时的平均年龄30.8±13.1岁(范围8-74)岁,男女比为0.9∶1。②继发性肾小球肾炎中,最常见的是紫癜性肾炎(38.9%),其次狼疮性肾炎(27.2%)、乙肝病毒相关性肾炎(10.9%)。③本组常见的临床表现依次是肾病综合征(47.5%),肾炎综合征(30.6%)、慢性肾衰竭(11.3%)、无症状尿检异常(4.5%)、急性肾衰竭(4.2%)及急进性肾小球肾炎(1.9%)。④表现为肾病综合征的常见病理类型依次是狼疮性肾炎(33.3%)、紫癜性肾炎(30.9%)、乙型肝炎病毒相关性肾炎(15.1%)。表现为慢性肾衰竭的常见病理类型依次是高血压肾损害(33.3%)、紫癜性肾炎(23.3%)、狼疮性肾炎(16.7%)。表现为急性肾衰竭的病理类型则以狼疮性肾炎(54.5%)及紫癜性肾炎(27.3%)为主。结论继发性肾小球肾炎以女性多见,成人及儿童继发性肾小球肾炎中紫癜性肾炎是首要病因。肾病综合征是最常见的临床表现,其最常见的病理类型是狼疮性肾炎;慢性肾衰竭最常见的病理类型是高血压肾损害;急性肾衰竭最常见的病理类型是狼疮性肾炎。     

肾活检107例临床病理分析

目的探讨肾活检在肾脏疾病中的诊断意义。方法在B超定位下,采用负压抽吸法,对肾病患者进行经皮肾活检术。参照2000年5月全国肾活检病理诊断研讨会制定的指导性意见,通过光镜及免疫荧光,明确病理诊断。结果取材成功并有完整病理资料肾活检病人107例,年龄12~75岁,平均年龄32.9岁。男性占39%,女性占61%。其中原发性肾小球病占69%,继发性肾小球病占31%。原发性肾小球病中,,IgA肾病发病率最高(36.5%),继发性肾小球病中以狼疮性肾炎(LN)最多(63.6%)。结论原发性肾小球病仍为常见的肾小球疾病,其中以IgA肾病最为常见,继发性肾小球病中以狼疮性肾炎(LN)多见。肾活检病理对肾脏疾病的诊断、治疗及评估预后有重要意义。     

101例克拉玛依地区肾活检病例资料分析

目的:分析当地肾活检资料特点,为当地肾脏疾病的诊治提供经验指导。方法:回顾性分析新疆克拉玛依市中心医院101例肾活检病例的临床病理资料资料进行统计学分析。结果:原发性肾小球肾炎占57.42%,其常见病理类型为非IgA肾病、IgA肾病,继发性肾小球肾炎占30.69%,其中以狼疮性肾炎最为常见,占45.21%。各病理类型分布在维吾尔族与汉族之间均无显著统计学差异,P>0.05(原发性肾小球肾炎男性多发,男:女为1.19:1,而继发性肾小球肾炎以女性为主,男:女为0.21:1),性别分布差异有统计学意义(P<0.05)。原发性肾小球肾炎中,汉族的高发年龄段为30~39岁,维吾尔族的高发年龄段为20~29岁.结论:原发性肾小球肾炎是本地区最常见的肾小球疾病,男、女均多发,其中以非IgA沉积型系膜增生性肾小球肾炎最为常见,继发性肾小球肾炎女性多见,狼疮性肾炎最常见。原发性肾小球肾炎中,汉族的发病年龄比维吾尔族的发病年龄晚。     

861例肾活检临床病理分析

目的 分析861例肾活检病理结果,以了解肾脏疾病的病理类型及其特点.方法 回顾性分析2008-01~2009-01间,861例因肾脏疾病行肾活检的病理资料,并进行统计和总结.结果 861例患者中,原发性肾小球疾病占85.6%,继发性肾小球病占13.4%,小管间质性疾病占0.8%,肾移植相关肾脏疾病占0.2%.原发性肾小...     

儿童肾活检977例病理及临床分析

目的回顾性分析小儿肾脏疾病的病理类型及临床特点。方法收集977例接受经皮肾活检患儿的病理诊断和临床资料,分析比较原发性肾小球疾病与继发性肾小球疾病的病理类型和临床特征。培果成功肾活检971例,其中原发性肾小球疾病755例（77．8％）,继发性肾小球疾病183例（18．8％）,先天性遗传性代谢性肾小球疾病18例（1．9％）。原发性肾小球疾病中,临床诊断前3位依次为孤立性血尿、肾病综合征和迁延性肾小球肾炎;病理类型前3位依次为肾小球轻微病变、局灶节段性肾小球硬化和局灶性肾小球肾炎。继发性肾小球疾病中,临床诊断前3位依次为紫癜性肾炎、乙型肝炎相关性肾小球肾炎和狼疮性肾炎;病理类型前3位依次为系膜增生性肾小球肾炎、肾小球轻微病变和膜性肾病。在18例先天性遗传性代谢性肾脏疾病中,有7例为薄基膜肾病。在临床诊断为孤立性血尿的患儿,肾活检病理类型中肾小球轻微病变所占百分比随患儿年龄的增长逐渐降低（P〈0．05）,而IgA肾病和局灶性肾小球肾炎所占百分比随患儿年龄的增长逐渐升高（P〈0．05）。结论本组资料中,儿童肾小球疾病以原发性肾小球疾病为主,临床表现和病理类型以血尿和肾小球轻微病变最为常见;小儿继发性肾小球疾病以紫癜性肾炎最为常见,病理类型以系膜增生性肾小球肾炎、肾小球轻微病变和膜性肾病为主;先天性遗传性肾脏疾病中薄基膜肾病最为常见。建议对6岁以上的孤立性血尿患儿行肾穿刺活检术。     

济宁市区184例肾活检病理资料分析

目的 分析济宁市区肾脏病患者肾脏病理类型构成,从而提高诊治水平.方法 回顾性分析我院2009年1月至2010年12月间经肾活检确诊的184例的肾脏病理与临床资料.结果 184例肾活检病理中,原发性肾小球疾病134例(72.83%)是最常见的肾脏疾病,其中IgA肾病最多见,占33.58%;继发性肾脏病以狼疮性肾炎、过敏性...     

353例小儿肾小球疾病的病理及临床分布特点

目的：了解小儿肾小球疾病病理与临床分布特点。方法收集353例肾活检患儿资料进行回顾性分析。结果353例患儿中诊断为紫癜性肾炎117例（33.1%）,孤立性血尿94例（26.6%）,原发性肾病综合征87例（24.6%）,急性肾炎综合征23例（6.5%）,其次还有乙肝相关性肾炎、狼疮性肾炎、孤立性蛋白尿、慢性肾炎等。肾小球疾病中以原发性肾小球疾病最为常见（206例,占58.4%）,病理改变主要为：系膜增生性肾小球肾炎（MsPGN）66例,占32.0%;IgA 肾病（IgA N）54例,占26.2%;轻微病变37例,占18.0%;其他还包括微小病变（MCD）、膜增生性肾小球肾炎（MPGN）、膜性肾病（MN）、毛细血管增生性肾小球肾炎等。继发性肾小球疾病以紫癜性肾炎最常见。结论肾小球疾病以原发性肾小球疾病为主,临床诊断以孤立性血尿最常见,继发性肾炎以紫癜性肾炎最常见。     

185例肾穿刺活检病例的病理与临床资料分析

目的：了解总结我院肾脏病的临床特点与病理分型。方法：对我院近4年185例行肾穿刺活检患者的临床特点和病理资料进行回顾性分析。结果：肾小球疾病（GN）182例,占98.4%;其中原发性肾小球疾病（PGN）133例占71.9%,继发性肾小球疾病（SGN）49例占26.5%;肾小管间质病变3例占1.6%。PGN中IgA肾病（IgAN）及系膜增生性肾小球肾炎（MsPGN）所占比例较高,分别为30.3%、14.6%。SGN中狼疮性肾炎（LN）、乙肝病毒相关性肾炎及过敏性紫癜性肾炎所占比例较高,分别为11.4%、4.3%、4.9%。结论：GN是我院肾活检病例中最常见原因,原发多于继发。PGN中IgAN最常见,其次为MsPGN;SGN中,LN是首要原因。肾活检对肾脏病的诊断、治疗及判断预后有重要意义。     

Pattern of renal pathology among renal biopsy specimens in Eastern Saudi Arabia

OBJECTIVE: To identify the pattern of renal pathology among renal biopsy specimens, and to study the clinical correlation in a general hospital in the eastern region of the Kingdom of Saudi Arabia. METHODS: All patients who underwent native kidney biopsy by the author at Dhahran Health Center (DHC) between June 1998 and April 2005 were included and prospectively followed-up. RESULTS: One hundred native kidney biopsies were performed on 95 patients with a mean age of 40.8+/-18 years, and a glomerular filtration rate of 57+/-42 ml/min/1.73 m2. Patients were followed up for a mean of 28+/-22.5 months. Primary renal pathology was identified in 72 specimens and secondary in 28. Primary renal pathologies included focal and segmental glomerulosclerosis (FSGS) (35%), immunoglobulin A nephropathy (IgAN) (14%), tubulo-interstitial nephritis (12%), minimal change disease (10%), membranous nephropathy (4%), mesangioproliferative glomerulonephritis (6%), mesangiocapillary glomerulonephritis (4%), thin glomerular basement membrane disease (8%), and miscellaneous (7%). Secondary lesions included lupus nephritis (LN) (36%), sickle cell nephropathy (SCN) (18%), diabetic nephropathy (14%), hypertensive nephrosclerosis (11%), Henoch Schonlein purpura (7%), and miscellaneous (14%). Obesity was particularly prevalent among patients with FSGS. Among the entire group, 12 patients (13%) progressed to end stage renal disease (ESRD) at a mean of 17.6+/-17 months (range, 1-45 months), and the overall mortality rate was 5.3%. CONCLUSION: At DHC, FSGS was the most common primary renal pathology, followed by IgAN. There was an association between FSGS and obesity. Lupus nephritis was the predominant secondary renal pathology followed by SCN. Within the time of follow up, primary renal lesions were associated with a low rate of progression to ESRD.     

Pathological demography of native patients in a nephrology center in China

Objective To analysis the pathological demography in Chinese patients undergoing renal biopsy from our niphrology center. Methods Between January 1979 and October 2000 in Jinling Hospital, Nanjing, China, 10002 attempts of percutaneous renal were performed in patients with renal disease from 33 provinces of China. The pathological classifications were made according to the WHO criteria of 1982 for renal pathology or the modified WHO criteria of 1995 by a panel of pathologists and nephrologists during routine clinical-pathological rounds. The pathological demography between those specimens collected from 1979-1989 and those from 1990-1999 was compared.Results The mean age of the 10 002 subjects undergoing renal biopsy was 31.4±13.0 years (ranging from 1 to 78 years), with a male to female ratio of 1.3∶1; for the 592 renal transplant recipients, the mean age was 37.5±9.1 years (ranging from 16 to 66 years), with a male to female ratio of 2.36∶1. Primary glomerular diseases (PGD) accounted for 71% of the total patients undergoing renal biopsies, secondary glomerular nephritis (SGN) 23%, tubular-interstitial diseases 3.2%, unclassified renal diseases 1.3%, hereditary and congenital renal diseases 1.0%, end stage renal diseases 0.96%, and recently realized or rare renal diseases 0.15%. IgA nephropathy (IgAN) was the most frequent pathological pattern (40%) of PGD, followed by mesangial proliferative lesion (MsPL) (30%), membranous nephropathy (MN) (10%), and focal segmental glomerulosclerosis (FSGS) (6%). Lupus nephritis (LN) was the most pathology common seen (74%) in SGN. During the 22 years of the study period, there was a steady increase in patients with SGN discovered during pathological evaluation of renal disorders. A rise in prevalence was found in IgA nephropathy, MN (both P&lt;0.001), crescentic glomerulonephritis (P&lt;0.0001), anti-GBM disease, and hemolytic-uremic syndrome/thrombotic thrombocytopenic purpura related renal damages (both P&lt;0.001). There was a decrease in endocapillary proliferative glomerulonephritis (P&lt;0.001) and IgM nephropathy (IgMN) (P&lt;0.01) from 1990-1999 as compared to 1979-1989. Infrequent renal pathological entities were also diagnosed in this group, including Niemann Pick disease, Fabry’s disease, POEMS syndrome, and lipoprotein glomerulonephropathy. Conclusions This is the largest series of renal biopsy data in China, and therefore may reflect the demographic picture of renal diseases in this country. Changes in prevalence of renal pathological entities were reflected in this group of patients over the last 22 years. In primary glomerular diseases, IgA nephropathy is still the most frequently observed pathological pattern. In SGN, LN appeared the most often. Increased prevalence was found in anti-GBM nephritis and HUS/TTP.