原发性肾小球疾病慢性肾功能不全278例临床与病理分析

目的：了解原发性肾小球疾病慢性肾功能不全(CRI)的临床与病理关系。方法：对278例原发性肾小球疾病CRI进行肾穿刺检查，结合临床类型、CRI分期进行分析。结果：慢性肾炎249例，病理为IgA肾病(IgAN)占45．0％，增生硬化肾炎(PSGN)占16．9％，硬化性肾炎(SGN)占18．5％，系膜增生性肾炎(MSPGN)占9．6％，膜增生性肾炎(MPGN)占2．4％，局灶节段肾小球硬化(FSGS)占2．0％，膜性肾病(MN)占2．0％，IgM肾病(IgMN)占2．8％，局灶增生性肾炎(FP)占0．8％。肾病综合征29例，病理为IgAN占41．4％，PSGN占10．3％，SGN占13．8％，MsPGN占20．7％，MPGN占10．3％，FP占3．5％。CRI各期均以IgAN占首位，代偿期病理改变较轻，失代偿期PSGN占20．6％，SGN占15．9％．肾衰期及尿毒症期PSGN占16．1％，SGN占37．1％。结论：CRI可见9种病理类型，CRI分期与病理改变程度密切相关。

Primary Glomerular Diseases with Chronic Insufficiency: Clinical and Pathological Analysis of 278 Cases

Objective:To understand the relationship between the clinical and pathological characteristics of primary glomerular diseases (PGD) with chronic renal insufficiency (CRI).Methods:Renal biopsies were obtained in 278 cases of CRI resulted from PGD in our department.Then analysis was made over the clinical types and CRI stages.Results:249 patient were diagnosed with chronic glomerulonephritis (CGN) in these study subjects.Pathologically,IgAN amounted for 45.0%;PSGN for 16.9%;SGN for 18.5%;MsPGN for 9.6%;IgMN for 2.8%;MPGN for 2.4%);FSGS for 2.0%;MN for 2.0%;FP for 0.8%.The other 29 cases were determined to have nephropatic syndrome and their pathological types were as follows:IgAN amounting for 41.4%,PSGN for 10.3%,SGN for 13.8%,MsPGN for 20.7%,MPGN for 10.3% and FP for 3.5%.IgAN was the most frequent in each stage of CRI.The pathological lesions were slighter in the compensation stage of CRI.On uncompensated stage,PSGN accounted for 20.6% and SGN for 15.9% of the cases on this stage.In renal failure and uremia stages,PSGN accounted for 16.1% and SGN 37.1%.Conclusions:9 pathological types were identified in CRI patients.CRI staging was closely correlated with the severity of pathological lesions of CRI.