成人原发性肾病综合征35例临床病理分析

目的探讨成人原发性肾病综合征病理特征与治疗的关系。方法应用免疫荧光染色、光镜及电镜回顾性分析了肾穿刺活检35例成人原发性肾病综合征的临床病理特点，病理诊断按1982年WHO标准确定。结果肾病理以系膜增生性最多，占28．3％，膜增生性次之，占20％；微小病变及膜性肾病分别占14．3％和11．4％。实验室检查：血IgG降低占68．5％，血a2球蛋白增高占80％。激素疗法完全或部分缓解在弥漫增生性肾炎为70％，在膜性肾病为75％，而在微小病变为100％。结论血中IgG降低及血a2球蛋白增高可作为肾病综合征的诊断参考。激素疗法以弥漫增生性最差，膜性肾病次之，微小病变型最佳。

Clinical pathological analysis of primary mephrotic syndrome in 35cases

Objective To explore the relationship between the Pathologic features of adult primary nephroticsyndrome and the treatment effect, Methods A retrospective analysis on 35 cases of adult primary nephroticsyndrome by renal puncture biopsy was carried out by immunofluorescence strain, light and electron microscopy observation, pathologic diagnosis was defined according to WHO(l982) classification. Results The results ofrenal pathology showed MsPGN was the highest at the rate of 28. 3%, MPGN came second at the rate of 20%,MCNS and MCN constituting -espectively l4. 3% and ll. 4%. The 70% cases of the diffuse proliferativeglomerulonephritis, 75% MCN and 100% MCNS were completely or partly cured by hormonotherapy. The resultsof laboratory detection showed the cases with reduced IgG in blood represented 20%, and increased a2 globulin inblood represented 8o% in the patients. Conclusions These abnormal changes with reduced IgG and increasedglobulin in blood may beregarded as diagnostic references of nephrotic syndrome The effects of diffuse proliferative glomerulonephritis showed the worst results, MCN came second and MCNS showed the best results for hormonotheapy.