妊娠高血压综合征患者肾脏穿刺结果分析

目的：探讨妊娠高血压综合征(妊高征)患者行肾脏穿刺活检的安全性及了解肾脏病理改变与临床表现的关系。方法：对2000年8月至2002年2月13例妊高征患者于产后2周内(9例)及2周后(4例)采用16G弹射针B超引导下行肾脏穿刺活检，标本分别进行光镜、免疫荧光及部分行透射电镜检查。结果：妊高征肾脏的病理改变表现多样，其中表现为毛细血管内增生性肾小球肾炎3例，膜性肾病改变3例，肾小球轻微病变2例，系膜增生性肾小球肾炎2例，妊娠性肾病2例，局灶性硬化性肾小球肾炎1例。结论：妊高征患者肾脏穿刺活检是安全可行的，妊高征患者的肾脏病理改变可表现为各种病理类型，与临床病情无相关性，符合继发性肾病综合征改变。应对有肾脏损害的妊高征患者作相应随访，以发现妊娠诱发的肾脏疾病。

The biopsy-proven kidney results in pregnancy induced hypertension

Objective To identify the safety of renal biopsy in pregnancy induced hypertention(PIH) and the relationship between the pathological type of kidney and clinical manifestation.Methods From August 2000 to February 2002,13 patients(9 cases within two weeks of postpartum and 4 cases after two weeks of postpartum) were performed renal biopsy under the direction of B ultrasound by 16G Tru cut needle.The samples were examined by microscopy and immunofluoroscopy.Some of them were observed under the transmission electron microscope.Results The pathological changes of kidney of PIH were varying-3 were endocapillary proliferative glomerulonephritis,3 were membranous nephropathy,2 minor glomerular abnormalities,2 mesangical proliferative glomerulonephritis,2 pregnancy induced kidney disease and 1 focal sclerosis.Conclusion The biopsy given to PIH patients is safe.The pathological changes of kidney are various,which are irrelevant to clinical course but compatible with the secondary nephrotic syndrome.So patients with kidney disorders should be followed up to find kidney disease induced by the pregnancy.