1224例肾活检病理资料分析

目的 探讨本院近5年1224例肾活检资料的流行病学特点及病理类型分布特征.方法 回顾性分析2008年1月至2012年12月1224例肾脏疾病经皮肾活检的病理类型.结果 1224例肾脏疾病患者行肾活检时的年龄范围为4 ～ 82岁,男661例,女563例.本组原发性肾小球疾病占81.70％,继发性肾小球疾病占12.17％,小管间质疾病占5.07％,代谢相关性肾病占0.82％,移植肾占0.16％,未确定诊断0.08％.原发性肾小球疾病以系膜增生性肾小球肾炎最为常见,占30.30％,其次分别为IgA肾病28.00％,膜性肾病17.50％,局灶节段性肾小球硬化10.50％,增生硬化性肾炎3.90％,膜增生性肾小球肾炎3.10％,新月体肾炎2.60％,微小病变性肾病2.50％,毛细血管内增生性肾小球肾炎1.60％.继发性肾损害最常见的继发肾脏病是狼疮性肾炎31.54％,其次分别是高血压肾损害27.52％,紫癜性肾炎13.42％,肾脏淀粉样变性11.4％,糖尿病肾病7.38％,乙肝病毒相关性肾损害2.68％,血栓性微血管病2.01％.结论 原发性肾小球疾病仍为最常见的肾小球疾病,其中以系膜增生性肾小球肾炎最为常见,IgA肾病次之.且IgA肾病发病率呈逐年上升趋势.另外,继发性肾脏病逐渐增多,继发性肾脏疾病中仍以狼疮性肾炎最为多见.通过肾活检和临床病理讨论,不仅能明确疾病的病理类型,更重要的是指导临床治疗,选择最佳的治疗方案,并对疾病的预后作出比较正确的判断.

Analysis of 1224 renal biopsy data

Objectives Explore our hospital for the past five years the epidemiological characteristics of 1224 cases of renal biopsy information and pathological type distribution characteristics. Methods Between Janu ary 2008 and December 2012 in the Peopleg Hospital of the Xinjiang Uygur Autonomous Region（ Urumqi , China） , 1224 attempts of pereutaneous renal biopsy were performed in renal patients. In this report , the pathologic entities were analyzed retrospectively. Results The age at renal biopsy rang of 4 to 82 years in 1224 patients with renal diseases with a male 661 cases, female 563 cases, primary glomerular diseases （PGD） accounted for 81.70% of the total renal patients biopsied , secondary glomerular nephritis （SGN） 12.17 % , Tubulointerstitial diseases 5.07 % and the associated nephropathy metabolic accounted for 0.82%, renal transplant recipients 0.16% , and unclassified renal diseases 0.08 %. mesangial proliferative lesion （MsPL） was the most frequent patholigic type （30.30 % ） of PGD ,followed by IgAN （28.00%） , membranous nephropathy（MN） （ 17.50 % ） , focal segmental glomeruloscle rosis （FSGS, 10.50 % ）. Proliferative selerosing glomerulonerphritis（ 3.9% ） , mcmbranoproliferative glomerulone phritis （3.10%）, crescentic glomcrulonephfitis （2.60%）, minimal change glomerulopathy（2.50% ）, endocapillary proliferative glomerulonephfitis （ 1.6% ） ,The most frequent type of SGN was lupusnephritis （LN） （31.54 % ） , Hy pertensive renal damage（27.52% ） , nephritis of anaphylactoid purpura （ 13.42% ）, amyloidosis（ 11.4% ）, diabetic renal （7.38%） , hepatitis B virus associated nephritis （2.68%）, Thrombotic micreangiopathy （2.01%）. Con clusions In primary glomerular diseases , mesangial proliferative lesion （MsPL） is still the most frequent patho logical type. followed by IgAN,and IgANshowed an increasing trend in the incidence. In addition, secondary renal disease gradually increased, In SGN , LN is the most frequent pathological type. Discussion by renal biopsy and clini cal pathology, not only clear the pathological type of the disease, more importantly, to guide clinical treatment, to choose the best treatment options, and the prognosis of the disease make a correct judgmen.