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目的：探索海拔在１ ８８５ｍ 的高海拔地区４２例经皮肾活检明确诊断的成人原发性肾病综合征的病理类型与疗效的关系。方法：在Ｂ超引导及Ｘ线静脉肾盂造影电视荧屏下定位于肾下极，采用Ｔｒｕ－ ｃｕｔ肾活检针穿刺，组织分送光镜（包括特染）、免疫荧光镜及电镜检查，分析病理与疗效的关系。结果：成人原发肾病综合征病理类型复杂，系膜增殖性肾炎为最常见的病理类型，其次为ＩｇＡ肾病、ＩｇＭ 肾病、膜增殖性肾炎、微小病变、膜性肾病、局灶性肾小球硬化、毛细血管内增殖性肾炎及新月体肾炎等类型。病理类型与糖皮质激素及免疫抑制剂疗效关系密切。结论：对成人原发肾病综合征应及时行肾活检，明确病理类型，制定因人而异的治疗方案。
Objective: To explore the relationship between pathological type and therapeutic effect of 42 cases of adult primary nephrotic syndrome diagnosed by percutaneous renal biopsy at an altitude of 1885m. Methods: B-guided ultrasonography and X-ray pyelography were used to screen the lower pole of the kidneys. Taken together, Tru-cut renal biopsy needle was used for puncturing, light microscopy (including special staining), immunofluorescence and electron microscopy were performed to analyze the pathology and Efficacy of the relationship. Results: The pathological types of adult primary nephrotic syndrome were complex. Mesangial proliferative glomerulonephritis was the most common pathological type, followed by IgA nephropathy, IgM nephropathy, membranoproliferative glomerulonephritis, minimal change, membranous nephropathy, focal glomerular Sclerosis, capillary proliferative nephritis and crescentic nephritis and other types. Pathological type and glucocorticoid and immunosuppressive agents are closely related to the curative effect. Conclusion: Kidney biopsy should be done in time for adult primary nephrotic syndrome. The pathological types should be clarified and different treatments should be made.