原发性肾小球疾病38例病理诊断与临床分析

作者报道38例原发性肾小球疾病肾活检病理诊断与临床诊断。38例中慢性肾小球肾炎16例,其光镜病理论断为系膜增殖性肾小球肾炎(MsPGN)7例,微小病变(MCD)3例,膜增殖性肾小球肾炎(MPGN)2例,局灶性肾小球硬化(FGS)3例,新日体性肾小球肾炎(CGN)1例。隐匿性肾小球疾病8例,其中MsPGN 5例,MCD,FGS及不能诊断各1例。肾病综合征7例,其中MCD3例,MsPGN、MPGN、FGS和终未期固缩肾(ESCK)各1例。其他临床诊断共7例,其中毛细血管内增殖性肾炎(PEGN)2例,MCD,CGN,CGN,ESCK,MPGN和MsPGN各1例。上述结果表明,病理诊断同临床诊断无固定性联系,但有倾向性联系。MsPGN共14例,有浮肿7例和蛋白尿10例中的8例经治疗后浮肿和蛋白尿消失,而血尿有7例仅3例消失。MCD共8例,有浮肿7例,蛋白尿5例,经治疗后均消失。由此说明MCD和MsPGN的浮肿及蛋白尿治效好,而MsPGN血尿疗效差。MPGN和FGS共9例,上述3项指标疗效均差。

Analysis on Pathology and Clinical Diagnosis for 38 Cases of Primary Glomerulopathy

This paper reports an analysis of pathology and clinical diagnosis for 38 cases of primary glomerulopathy. Among them 16 persons were diagnosed by light microscope(LM) examination as having chronic glomerulonephritis, 7 having mesangial proliferative glomerulonephritis (MsPGN),3 minimal changing disease (MCD), 2 membranous proli-ferative glomerulonephritis( MPGN) , 3 focal glomerulosderosis(FGS), and 1 crescentic glomerulonephritis(CGN). There were 8 cases of latent glomerulopathy(LGN), in which 5 were MsPGN, 1 MCD, 1 FGS, and 1 case was not diagnosed Nepbrotic syndrome was diagnosed clinically in 7 cases, in which 3 were MCD, 1 MsPGN, 1 MPGN.lFGS and 1 end stage contracted kidney (ESCK). Other clinical diagnosis were made in 7 cases, in which 1 MsPGN,! MPGN.1CGN, 1 MCD, 1 ESCK and 2 proliferative endocapillary glomerulonephritis(PEGN).The results mentioned above show that there is no fixed relation between the pathologic diagnosis and the clinical diagnosis, but some relations between them exist. In 8 cases of MCD, 5 had proteinuria, 7 had edema After treatment both proteinuria and edema disappeared None of them had hemoturia. In 14 cases of MsPGN 7 had edema which disappeared after treatment, and 10 had proteinuria which disappeared in 8 cases after treatment I n 7 cases of hemoturia 3 responded well to treatment It is shown that edema and proteinuria of MsPGN respond well to treatment ,but hemoturia did not . Nine cases of MPGN and FGS respondes poor with respect to proteinuria and hemoturia. Edema and proteinuria in one of the 2 cases of CGN disappeared, but the hemoturia remained.