2589例肾活检标本电镜检查病理诊断分析

发布时间：2018-02-26 03:21

  本文关键词： 肾脏疾病 肾活组织检查 电子显微镜 病理类型 回顾性分析　出处：《广西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的 探讨2589例肾活检患者流行病学特点、病理类型分布；客观如实的评估电镜检查在肾脏病病理诊断中的作用。方法 回顾性分析我院2589例肾活检患者的一般资料、光镜联合免疫荧光检查及电镜检查的资料,将电镜检查结果作为最终诊断,统计最终病理类型的分布,并与光镜联合免疫荧光所作的初步诊断作比较,评估电镜检查在肾脏疾病病理诊断中所起的作用。将核实后的资料录入计算机,采用EXCEL及SPSS软件建立数据库,运用SPSS16.0软件进行分析处理。结果 (1)患者行活检时平均年龄37.77±16.06(1～89)岁,男女之比为0.96：1;原发性肾小球疾病占73.46%,继发性肾脏疾病占25.07%;原发性肾小球疾病的病理类型中最多见为膜性肾病(33.23%),其次为微小病变性肾小球肾炎(21.82%)和IgA肾病(18.72%)。(2)继发性肾脏疾病病理病理类型中以狼疮性肾炎居首位(76.12%),其次为糖尿病肾病(8.32%)和血管炎肾损害(3.70%)；狼疮性肾炎男女之为1：6.72病理类型最多为Ⅳ型(40.49%)及V型(28.34%)。(3)遗传性肾小球疾病较少,主要为薄基底膜肾病及Alport综合征。(4)电镜检查对肾活检病理诊断起决定诊断作用的病例占17.27%,起修正补充作用的病例占23.10%,而起验证作用者占59.63%;电镜检查对40.36%的肾活检最终病理诊断提供有价值信息,而光镜免疫荧光联合检查对59.64%的病例可独立诊断(X2=192.35,P=0.000)。结论 (1)本组行肾穿刺活检的患者多为青壮年,以原发性肾脏疾病最常见,其中膜性肾病是最多见的病理类型,其次为微小病变肾小球肾炎和IgA肾病；我院膜性肾病比例呈明显上升趋势,且高于国内其他地区。(2)狼疮性肾炎是最多见继发性肾脏疾病的病理类型,其次为糖尿病肾病和血管炎肾损害。(3)本组研究中遗传性肾小球疾病比例较少,主要为薄基底膜肾病及Alport综合征。(4)行电镜检查对肾脏疾病病理诊断非常必要,应该常规留取肾组织标本进行电镜检查。
[Abstract]:Objective to investigate the epidemiological characteristics and pathological type distribution of 2589 renal biopsy patients, and to evaluate the role of objective electron microscopy in the diagnosis of renal diseases. Methods the general data of 2589 renal biopsy patients in our hospital were retrospectively analyzed. The results of light microscopy combined with immunofluorescence and electron microscopy were regarded as final diagnosis, and the distribution of final pathological types was analyzed and compared with the preliminary diagnosis made by light microscope combined with immunofluorescence. To evaluate the role of electron microscopy in the pathological diagnosis of renal diseases. The verified data were input into the computer, the database was established by EXCEL and SPSS, and the data was analyzed by SPSS16.0 software. Results: the average age of biopsy was 37.77 卤16.061.89 years old. The ratio of male to female was 0.96: 1; primary glomerular disease was 73.46; secondary renal disease was 25.07; membranous nephropathy was the most common pathological type of primary glomerular disease, followed by minimal change glomerulonephritis 21.82) and IgA nephropathy was 18.72%. Among the pathological types of renal diseases, lupus nephritis was the most common pathological type, followed by diabetic nephropathy (8.32T) and vasculitis (3.70%), lupus nephritis (16.72%), type 鈪，

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