绵阳地区成人肾小球疾病127例临床病理分析

目的了解绵阳地区成人肾小球疾病的病理类型及其特点。方法回顾我院2008年1月～2011年8月经肾活检确诊的127例成人肾小球疾病患者的临床资料,分析其年龄性别分布、肾病理类型及其与临床表现的关系。结果127例成人肾小球疾病患者,原发性肾小球疾病95例(74.80%),男∶女=1∶1.88;继发性肾小球疾病32例(25.20%),男∶女=1∶1.13。成人原发性肾小球肾炎病理类型主要为IgA肾病,其它有肾小球微小病变、膜性肾病和系膜增生性肾小球肾炎等。成人继发性肾小球肾炎病理类型主要为狼疮性肾炎,其它有过敏性紫癜肾炎、乙型肝炎相关性肾炎、系统性血管炎和肾淀粉样变等。原发性肾小球疾病临床表现蛋白尿和(或)血尿占30.71%,肾病综合征占50.39%,急性肾炎综合征占7.87%,急性肾衰竭占11.02%。结论经肾活检肾脏疾病在绵阳地区以青壮年多见,本地区最常见的肾小球疾病为原发性肾小球肾炎,女性多发,其中IgA肾病是最多见的病理类型。成人继发性肾小球肾炎病理类型以狼疮性肾炎最常见。肾小球疾病每种病理类型可有多种临床表现,而每种临床表现亦可有多种病理类型。

Analysis of pathological types and features of glomerular diseases in adults in Mianyang area

Objective To investigate the pathological types and features of glomerular diseases in adults in Mianyang area.Methods The data on 127 patients with glomerular diseases confirmed by renal biopsies with definite pathologic diagnosis in our hospital between Jan.2008 and Aug.2011 were reviewed retrospectively.Distribution of age and sex,glomerular pathological types and relationship with clinical features were analyzed.Results 127 cases of adult glomerular diseases,95 case was primary glomerular diseases,accounting for 74.80%.The ratio of male to female was 1/1.88.32 cases was secondary glomerular diseases,accounting for 25.20%.The ratio of male to female was 1/1.13.IgA nephropathy(IgAN)was the most common primary glomerular diseases,followed by minimal change disease,membrane nephropathy,and mesangial proliferative glomerulonephritis,ea al.Lupus nephritis(LN)was the most common secondary glomerular diseases,followed by Henoch-Schonlein purpura nephritis,nephritis associated with hepatitis B,systemic vasculitis and renal amyloidosis,ea al.Clinical features included proteinuria and/or hematuria 30.71%,nephrotic syndrome 50.39%,acute nephritic syndrome 7.87% and acute renal failure 7.87%.Conclusion The most common renal disease occurred in adults in Mianyang area is primary glomerular disease.IgAN is predominant and the adolescent are in high risk for primary glomerular disease.LN is the most common in secondary glomerular diseases.Each pathological type of glomerular disease may present a variety of clinical manifestations,and each manifestation has different pathological types.