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目的明确因肾脏疾病行经皮肾组织活检患者的病理分型构成及其与临床分型的关系。方法参照WHO(1982年及1995年)肾小球疾病组织学分型修订方案以及2001年我国的肾脏病理诊断标准修正方案,回顾性分析1981年1月—2007年3月的5 000例肾活检患者的临床资料、实验室检查结果、免疫病理及超微病理的改变特点,最后与临床医师共同探讨明确诊断,总结5 000例肾活检患者的病理结果。结果患者行肾活检时年龄为4～86岁,平均年龄为(35.5±11.4)岁,男女之比为1.95∶1。原发性肾小球疾病是最常见的肾脏疾病(77.40%),其病理类型中最多见者为系膜增生性肾小球肾炎(42.14%),其次为IgA肾病(26.18%)。继发性肾小球疾病占肾脏疾病的19.44%,其病理类型中最多见者为狼疮性肾炎(33.74%),其次为紫癜性肾炎(32.20%),再次为乙肝病毒相关性肾炎(8.02%)。结论本分析资料显示肾脏疾病多见于青壮年男性,以原发性肾小球疾病最常见,其中系膜增生性肾小球肾炎是最常见的病理类型,其次为IgA肾病。继发性肾小球疾病以狼疮性肾炎和紫癜性肾炎多见。
Objective To clarify the pathological classification of patients with percutaneous nephrostomy due to renal diseases and its relationship with clinical classification. Methods According to WHO (1982 and 1995) revision of histological classification of glomerular disease and revision of the diagnostic criteria of renal pathology in China in 2001, 5 000 cases of renal biopsy from January 1981 to March 2007 were retrospectively analyzed Clinical data, laboratory test results, immunopathology and ultrastructural changes, and finally discuss with clinicians a clear diagnosis, summarize the pathological findings of 5 000 cases of renal biopsy. Results The patients were aged 4 to 86 years undergoing kidney biopsy. The average age was (35.5 ± 11.4) years. The ratio of male to female was 1.95:1. Primary glomerular disease is the most common renal disease (77.40%). The most common pathological type is mesangial proliferative glomerulonephritis (42.14%), followed by IgA nephropathy (26.18%). Secondary glomerular diseases accounted for 19.44% of all kidney diseases. The most common pathological types were lupus nephritis (33.74%), followed by purpura nephritis (32.20%), hepatitis B virus-associated nephritis (8.02% ). Conclusion This analysis shows that kidney disease more common in young men, the most common primary glomerular disease, mesangial proliferative glomerulonephritis is the most common pathological type, followed by IgA nephropathy. Secondary glomerular diseases with lupus nephritis and purpuric nephritis more common.