目的:探讨电镜检查在肾病综合征(NS)肾活检病理诊断中的作用.方法:对403例NS患者的肾活检组织进行透射电镜检查,分析电镜结果对最终诊断的意义.结果:"电镜对诊断起决定性作用"144例(35.7%),"电镜对诊断具有重要价值"77例(19.1%),"电镜对诊断非必需"182例(45.2%).NS组中"电镜有诊断价值"("决定性作用"+"重要价值")的比例高于非NS组(NS:非NS=54.8%:32.2%,P<0.01)."电镜有诊断价值"的比例因NS的病因、年龄和性别的不同存在组间差异,P<0.01(原发性NS:继发性NS=77.4%:7.5%;年龄<20岁组:20岁~40岁组:≥60岁组=74.4%:52.1%:45.8%;男:女=68.0%:42.2%).结论:电镜检查对NS的正确病理诊断具有重要的意义.NS肾活检确诊对电镜的依赖程度受患者性别、年龄及病因等因素的影响.%Objective: To evaluate the role of the transmission electron microscopy ( TEM ) for the renal biopsies diagnosis of nephrotic syndrome. Methods: TEM was used to examine the renal biopsy tissues and elevated its contribution for the final diagnosis in 403 cases of the nephritic syndrome patients. Results: TEM played a crucial role for making the final diagnosis with 35. 7% , provided important diagnostic information with 19. 1% , of all cases, respectively. The proportion of "TEM provided valuable diagnostic informations for the correct diagnosis" ( "crucial role" and "important information" ) in NS group was higher than that in the non - NS group ( 54. 8% vs. 32. 2% ,P <0. 01 ). The contribution of TEM in diagnosing of NS was influenced by etiology, gender and age, respectively, P <0. 01. Such as :Primary NS: Secondary NS = 77. 4%: 7.5% ; Age <20 y: 20~40 y and ≥60 y =74.4%:52.1% and 45. 8% ; Male: Female = 68.0% :42. 2% . Conclusion: TEM shows a useful pathological diagnosis of nephrotic syndromes which including play a crucial role and provide important diagnostic information . Furthermore, the values of TEM were influenced by gender, age and etiology of nephrotic syndromes.
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