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目的:探讨肾移植术后肾病复发和新发患者的临床及病理特点。方法:选取南京军区福州总院行移植肾活检的患者111例,其中A组为移植肾肾病复发和新发51例;B组为慢性移植物肾病60例;C组为与A组患者接受同一供肾38例。观察患者术前一般状况、术后穿刺前1周的检验结果及移植肾1、3、5年的存活情况并分析结果。结果:①A组肾病类型及例数:IgAN 15例,FSGS 10例,MPGN 9例,MsPGN 9例,MN 6例,SLE-LN2例。②穿刺前1周SCr、BUN及蛋白尿:A组明显大于C组。③A组移植肾5年存活率明显低于C组,三组移植肾1年、3年存活率无明显差异。结论:①复发和新发肾病以IgAN、FSGS、MPGN较为常见;②肾病复发和新发患者在肾功能异常时,肾功能及蛋白尿均较同一供肾组严重;③复发和新发肾病对移植肾短期存活无明显影响,但可降低其长期存活率。
Objective: To investigate the clinical and pathological features of relapsed and newly diagnosed nephropathy patients after renal transplantation. Methods: A total of 111 renal transplant recipients were enrolled in the Fuzhou General Hospital of Nanjing Military Command. Among them, 51 cases were relapsed and newly diagnosed as nephropathy in group A, 60 cases were chronic graft nephropathy in group B, 38 cases of kidney. The general status of the patients before operation, the results of the first week after the operation and the survival of the kidney in one, three, and five years after the operation were observed and the results were analyzed. Results: ①The type and number of nephropathy in group A were 15 cases of IgAN, 10 cases of FSGS, 9 cases of MPGN, 9 cases of MsPGN, 6 cases of MN and 2 cases of SLE-LN. ② 1 week before puncture SCr, BUN and proteinuria: A group was significantly larger than C group. ③ The 5-year survival rate of grafted kidneys in group A was significantly lower than that in group C, and there was no significant difference in 3-year survival rates among the three groups. Conclusion: (1) IgAN, FSGS and MPGN are more common in recurrent and nephridial nephropathy; (2) renal function and albuminuria are more severe than those in the same donor group when recurrence of nephrotic disease and new onset of renal dysfunction; (3) relapse and nephropathy Transplant renal short-term survival had no significant effect, but can reduce its long-term survival.