肾病综合征患者肾活检组织的透射电镜病理学研究

目的:探讨电镜检查在肾病综合征(NS)肾活检病理诊断中的作用。方法:对403例NS患者的肾活检组织进行透射电镜检查,分析电镜结果对最终诊断的意义。结果:"电镜对诊断起决定性作用"144例(35.7%),"电镜对诊断具有重要价值"77例(19.1%),"电镜对诊断非必需"182例(45.2%)。NS组中"电镜有诊断价值"("决定性作用"+"重要价值")的比例高于非NS组(NS∶非NS=54.8%∶32.2%,P<0.01)。"电镜有诊断价值"的比例因NS的病因、年龄和性别的不同存在组间差异,P<0.01(原发性NS∶继发性NS=77.4%∶7.5%;年龄<20岁组∶20岁～40岁组∶≥60岁组=74.4%∶52.1%∶45.8%;男∶女=68.0%∶42.2%)。结论:电镜检查对NS的正确病理诊断具有重要的意义。NS肾活检确诊对电镜的依赖程度受患者性别、年龄及病因等因素的影响。

Evaluation of Transmission Electron Microscopic in the Renal Biopsies of Nephrotic Syndrome Patients

Objective:To evaluate the role of the transmission electron microscopy(TEM) for the renal biopsies diagnosis of nephrotic syndrome.Methods:TEM was used to examine the renal biopsy tissues and elevated its contribution for the final diagnosis in 403 cases of the nephritic syndrome patients.Results:TEM played a crucial role for making the final diagnosis with 35.7%,provided important diagnostic information with 19.1%,of all cases,respectively.The proportion of "TEM provided valuable diagnostic informations for the correct diagnosis"("crucial role" and "important information") in NS group was higher than that in the non-NS group(54.8% vs.32.2%,P<0.01).The contribution of TEM in diagnosing of NS was influenced by etiology,gender and age,respectively,P<0.01.Such as :Primary NS∶ Secondary NS=77.4%∶ 7.5%;Age <20 y∶ 20～40 y and ≥60 y =74.4%∶ 52.1% and 45.8%;Male:Female=68.0%:42.2%.Conclusion:TEM shows a useful pathological diagnosis of nephrotic syndromes which including "play a crucial role" and "provide important diagnostic information".Furthermore,the values of TEM were influenced by gender,age and etiology of nephrotic syndromes.