深圳地区1555例肾活检病理资料及流行病学特点

目的通过对深圳地区近20年肾脏病理类型的回顾性分析,了解深圳地区肾脏疾病谱的构成及其演变趋势。方法回顾性分析2012~2019年1555例肾脏疾病经皮肾活检患者的病理类型,并与2000~2007年615例肾穿刺活检患者的数据进行对比。结果 1555例患者中,男892例(57.4%),女例663例(42.6%);男女比例1.35∶1;平均年龄(38.35±12.85)岁。原发性肾小球肾炎1171例(75.3%),继发性肾小球肾炎340例(21.9%),肾小管间质疾病27例(1.7%),遗传性肾病11例(0.7%),其他6例(0.4%)。2012~2019年膜性肾病、系膜增生性病变占比明显高于2000~2007年,微小病变肾病占比明显低于2000~2007年,差异具有统计学意义(P<0.05);2012~2019年糖尿病肾病、高血压肾损害占比明显高于2000~2007年,狼疮性肾炎占比明显低于2000~2007年,差异具有统计学意义(P<0.05);2016~2019年继发性肾小球疾病、肾小管-肾间质疾病占比高于2012~2015年,原发性肾小球疾病占比低于2012~2015年,差异具有统计学意义(P<0.05);2016~2019年IgA肾病占比明显高于2012~2015年,微小病变肾病占比明显低于2012~2015年,差异具有统计学意义(P<0.05);2016~2019年糖尿病肾病、高血压肾损害占比明显高于2012~2015年,狼疮性肾炎占比明显低于2012~2015年,差异具有统计学意义(P<0.05)。结论肾活检患者中最常见的仍是原发性肾小球疾病。免疫球蛋白A(IgA)肾病和狼疮肾炎分别是最常见的原发性和继发性肾小球疾病。在原发性肾病中膜性肾病、继发性肾病中糖尿病肾病和高血压肾损害的发病率明显增加。

Pathological data and epidemiological characteristics of renal biopsy in 1555 cases in Shenzhen

Objective To understand the constitution and evolution trend of kidney disease spectrum in Shenzhen area by retrospective analysis of kidney pathology types in recent 20 years. Methods A retrospective analysis was performed on the pathological types of percutaneous renal biopsy in 1555 cases of renal diseases from2012 to 2019, and compared with the data of renal biopsy of 615 patients in Shenzhen from 2000 to 2007. Results Of the 1555 patients, 892 cases were male(57.4%) and 663 cases were female(42.6%). The male-to-female ratio was 1.35: 1;the average age was(38.35±12.85) years old. There were 1171 cases of primary glomerulonephritis(75.3%), 340 cases of secondary glomerulonephritis(21.9%), 27 cases of tubulointerstitial disease(1.7%), 11 cases of hereditary nephropathy(0.7%), and 6 cases of other diseases(0.4%). In 2012-2019, the proportion of membranous nephropathy and mesangial proliferative lesions was significantly higher than that in 2000-2007, and the proportion of minimal change nephropathy was significantly lower than that in 2000-2007. The difference was statistically significant(P<0.05). In 2012-2019, the proportion of diabetic nephropathy and hypertensive renal damage was significantly higher than that in 2000-2007, and the proportion of lupus minimal change nephropathy in 2000-2007. The difference was statistically significant(P<0.05). In 2016-2019, the proportion of secondary glomerular diseases and tubulo-renal interstitial disease was higher than that in 2012-2015, and the proportion of primary glomerular diseases was lower than that in 2012-2015. The difference was statistically significant(P<0.05). In 2016-2019, the proportion of IgA nephropathy was significantly higher than that in 2012-2015, and the proportion of micro pathological nephropathy was significantly lower than that in 2012-2015. The difference was statistically significant(P<0.05). In 2016-2019, the proportion of diabetic nephropathy and hypertensive renal damage was significantly higher than that in 2012-2015, and the proportion of lupus nephritis was significantly lower than that in 2012-2015. The difference was statistically significant(P<0.05). Conclusion Primary glomerular disease remains the most common in patients with renal biopsy. Immunoglobulin A(IgA) nephropathy and lupus nephritis are the most common primary and secondary glomerular diseases, respectively. The incidence of diabetic nephropathy and hypertensive renal damage was significantly increased in primary nephropathy, membranous nephropathy, and secondary nephropathy.