548例肾脏疾病患者临床及病理分析

目的总结本院548例肾活检患者肾脏病理类型以及不同年龄段肾脏疾病的构成比,分析慢性肾脏病(CKD)分期、临床分型与病理分型之间的关系。方法回顾分析2007年1月至2013年6月在本院行肾活检的慢性肾脏病患者的性别、年龄、病理类型、CKD分期、临床分型等相关资料。结果 548例患者行肾活检时平均年龄为(35.48±15.79)岁,男性占48.2%。其中原发性肾小球疾病占81.5%,IgA肾病最常见(40.5%);继发性肾脏疾病占16.5%,狼疮性肾炎发病率最高(50.8%),其次是紫癜性肾炎(17%)。年龄18岁的患者以肾小球轻微病变最为多见、年龄≥60岁的老年患者以膜性肾病和糖尿病肾损害最常见;非老年组肾功能显著优于老年组;最常见的临床类型为肾病综合征和肾炎综合征。结论原发性肾小球疾病是最常见的肾脏疾病,好发于中青年;不同年龄段病理类型存在明显差别;肾病综合征是最常见的临床表现。

Clinical and pathological analysis of 548 cases with chronic kidney disease

Objective To summarize the renal pathological patterns of 548 attempts of kidney biopsy and the age-specific pathologic features, and analyze the relationships among chronic kidney disease （CKD） stage, clinical classification and pathological type. Method The clinical data including sex, age, pathological type, CKD stage and clinical classification of 548 cases having underwent renal biopsy in No. 1 people＇s hospital of Guangzhou were analyzed retrospectively. Results Of 548 patients, the mean age was （35.48＋15.79） years old and 48.2% patients were male. The proportion of primary glomerular diseases （PGD） was 81.5%, and IgA nephropathy was the most common pathological type （40.5%）. Secondary glomerul-onephritis （SGN） was accounted for 16.5% in all subjects. The most frequent subtype of SGN was lupus nephritis （50.8%）, followed by Henoch-Schonlein purpura glomerulonephritis （17%）. Mild glomernlar lesions was prevalent in patients under 18 years old. The most common pathological types of patients over 60 years old were membraneous nephropathy and diabetic nephropathy. Renal function of the other groups was significantly better than the elder group. The most frequent clinical pattern was nephrotic syndrome （NS） and chronic nephritic syndrome. Conclusions PGD was the most frequent disease. The pathological types of CKD in different age period were significantly different, and the most frequent clinical pattern was NS.