2874例肾病患者病理类型及其临床特征分析

摘要

Objective The aim of this study was to analyze the characteristics ot patients with chronic kidney disease (CKD) in Southern parts of Hebei province.Methods Records of 2874 CKD patients during January,2008 to May,2011 were retrospectively reviewed.Demographic,clinical and histo-pathological data were analyzed and compared to ones from the past five years.Results The age distribution of the groups was between 16 and 84 years old,with 62.39％ of them between 20 and 50.All patients underwent renal biopsy that with primary glomerulonephritis occurring in 1966 cases (68.41％),secondary glomerulonephritis in 826 cases (28.74％).The frequently seen pathological patterns were IgA nephropaty ( IgAN ),membranous nephropathy (MN) and minimal change disease (MCD) in proper order in the former group while Henoch-Schonlein purpura nephritis (HSPN) and lupus nephritis (LN) were seen in the latter group.Comparing to data of the past five years,the incidence rates of MN,MCD and HBV-GN increased to 16.84％,15.73％and 4.41％ respectively,but all IgAN,HSPN and LN had respectively decreased to 24.70％,5.50％ and 6.65％.MN,IgAN,MCD were commonly appeared in histo-pathological patterns among patients over 50 years of age.Conclusion IgAN was still the most commonly seen renal disease.Compared to data of the past five years,the incidence rates of MN,MCD and HBV-GN showed an increase at different levels.Epidemiological and pathological pattern of patients with CKD in Southern Hebei province had only mild changes over the last 3 years.%目的 了解河北省南部地区慢性肾病病理类型及其临床特征.方法 回顾性分析2008年1月至2011年5月2874例因肾病而行肾活检患者的病理类型和临床特征,并与5年前资料对比.结果 2874例患者年龄16 ～ 84岁,其中20 ～ 50岁者占62.39％,男女比例为1.23∶1.原发性肾小球肾炎1966例(68.41％),继发性肾小球肾炎826例(28.74％),肾小管-间质病变79例(2.75％),遗传性疾病3例.原发性肾小球肾炎中最常见病理类型依次为IgA肾病(IgAN)、膜性肾病(MN)和微小病变肾病(MCD)；与5年前资料比较:IgAN所占比例略有下降(24.70％vs.26.00％),MN比例升高(16.84％vs.10.80％),MCD比例略有上升(15.73％vs.13.20％).继发性肾小球肾炎中以紫癜性肾炎(HSPN)和狼疮性肾病(LN)较常见,与5年前资料比较均有所下降(分别为5.50％vs.7.00％,6.65％vs.6.80％),而HBV相关性肾炎(HBV-GN)所占比例显著升高(4.41％vs.0.96％).50岁以上肾病患者的最常见病理类型依次为MN、IgAN、MCD.结论 慢性肾病以原发性肾小球肾炎居多.IgAN仍是最为常见的肾小球疾病,且与5年前资料相比,MN、MCD和HBV-GN患者比例均有升高.