四川地区肾活检2330例临床病理分析

目的：探讨四川地区肾穿刺活检病理类型的分布特点以及疾病谱的变迁。方法回顾性分析2330例肾活检患者的临床病理资料,分析本地区肾脏疾病的临床病理特征。结果2330例肾活检患者中,男女比例为1∶1.15,发病高峰年龄为20~40岁。2330例患者中,原发性肾小球疾病1896例（占81.37%）,常见的病理类型依次为 IgA 肾病820例（占35.19%）、系膜增生性肾小球肾炎372例（占15.97%）、膜性肾病298例（占12.79%）、微小病变肾病200例（占8.58%）和局灶节段性肾小球硬化症78例（占3.35%）；继发性肾小球疾病367例（占15.75%）,以狼疮性肾炎最常见（134例,占5.88%）,其次为紫癜性肾炎127例（占5.45%）、糖尿病肾脏疾病35例（占1.5%）和淀粉样变性肾病20例（占0.86%）；肾小管间质疾病50例（占2.15%）；遗传性肾病17例（占0.73%）。2330例肾脏疾病患者的临床表现依次为肾病综合征1015例（占43.56%）、慢性肾炎综合征681例（占29.22%）、急性肾炎综合征392例（占16.82%）、隐匿性肾小球肾炎121例（占5.29%）、慢性肾衰竭72例（占3.09%）、急性肾衰竭47例（占2.02%）。近年来,膜性肾病构成比呈逐渐增加趋势。结论本地区肾脏疾病多见于青壮年,以原发性肾小球疾病最常见,其中 IgA 肾病和系膜增生性肾小球肾炎是最多见的病理类型,膜性肾病的检出率有增高趋势。继发性肾小球疾病以狼疮肾炎和紫癜性肾炎最常见。

Analysis of 2 330 cases of renal biopsy in Sichuan area

Objective To investigate the pathological characteristics as well as their associations with secular trend of the disease of renal biopsies in Sichuan area.Methods The pathological data of 2 330 patients with biopsy-proven glomerular diseases were analyzed retrospectively.Results The male to female ratio was 1∶1.15 in 2 330 patients,and the patients aged 20-40 years old accounted for the highest percentage in renal diseases.Among the 2 330 patients,primary glomerulonephritis （PGN,81.37%）was of the most frequent type,followed by secondary glomerulonephritis （SGN, 15.75%）,tubulointerstitial nephritis （TIN,2.15%）and hereditary kidney disease （0.73%）.Among PGN,IgA nephropathy was the most frequent pathology type,followed by mesangial proliferative glomerulonephritis （MsPGN）,membranous nephropathy （MN）,minimal change disease （MCD）and focal segmental glomerulosclerosis （FSGS）.Lupus nephritis （LN）was the most common form of SGN,followed by henoch-schonlein purpura nephritis （HSPN）,diabetic kidney disease（DKD）and amyloidosis （AL）.There were 1015 patients （43.56%）with kidney disease nephrotic syndrome,681 （29.22%）with chronic nephritic syndrome,392 （16.82%）with acute nephritic syndrome,121 （5.29%）with occult glomerulonephritis,72（3.09%）with chronic renal failure and 47（2.02%）with acute renal failure in the clinical classification of 2330 patients.Recently,the incidence of MN was in-creased.Conclusions PGN is the most common histological type in Sichuan area,and young men are more inclined to suffer from it.IgAN and MsPGN are the most common types in PGN,and the inci-dence of MN has been increased.For SGN,LN and HSPN are the most frequent types.