142例肾病综合征临床与病理分析

发布时间：2018-03-26 17:00

本文选题：肾病综合征　切入点：临床表现　出处：《吉林大学》2014年硕士论文

【摘要】：目的：对于近几年我院肾病综合征患者病理类型分布特征、男女比例及病理类型分布与临床表现的关系，，为肾病综合征的治疗及诊断提供价值资料。方法：分析2011年11月～2013年10月，因肾脏疾病在期间入院行肾活检并以肾病综合征为临床表现的患者为资料，查阅其实验室检查，结合肾病综合征患者肾穿刺病理活检的结果，回顾性分析病理特点与临床特征之间的关系。结果：肾病综合征是最常见的临床表现。73例患者中以男性为主（51.4%），肾病综合征发病高峰年龄为40-60岁，占47.2%。病理类型中原发性肾病综合征（PNS）发病率最高（占65.5%），男：女为1.21：1。PNS中最为常见病理类型是膜性肾病，占41.9%，男：女为2.25：1；其次为微小病变性肾病（18.3%）、IgA肾病（14%）。不典型膜性肾病是继发性肾病综合征（SNS）的常见病理类型（53.1%），其次为狼疮性肾炎（24.5%），乙型肝炎病毒相关性肾炎（6.1%）。通过经肾穿刺活检的肾病综合征患者的病理类型分析，针对无法开展肾活检的医院或有肾穿刺禁忌症的患者，依据病人年龄和性别并结合临床检验结果，初步推断肾脏病理变化轻重，指导进一步治疗、判断预后病情情况。结论：肾病综合征基础肾脏病的病理类型决定其预后。原发性肾病综合征（PNS）仍是肾脏疾病的主体，以膜性肾病发病率最高。继发性肾病综合征（SNS）以不典型膜性肾病为主。肾穿刺活检对肾脏疾病的诊断、治疗及判断预后方面有重大意义，临床与病理相结合的诊断及治疗的重要意义比单纯的临床诊断和治疗要高。
[Abstract]:Objective: to provide valuable data for the treatment and diagnosis of nephrotic syndrome in our hospital in recent years. Methods: from November 2011 to October 2013, renal biopsy was performed during the period of renal disease, and the clinical manifestations of nephrotic syndrome were analyzed. The results of laboratory examination were reviewed and combined with the results of renal biopsy in patients with nephrotic syndrome. The relationship between pathological features and clinical features was analyzed retrospectively. Results: Nephrotic syndrome was the most common clinical manifestation. Among 73 patients, 51.4% were male. The peak age of nephrotic syndrome was 40-60 years old. The incidence of primary nephrotic syndrome (PNS) was the highest (65.5%). The most common pathological type in male and female 1.21:1.PNS was membranous nephropathy. 41.9%, male: female 2.25: 1, followed by minimal change nephropathy 18.3% IgA nephropathy. Atypical membranous nephropathy is a common pathological type of secondary nephrotic syndrome (SNS), followed by lupus nephritis 24.5b and hepatitis B virus associated glomerulonephritis 6.1B. Analysis of pathological types of Nephrotic Syndrome patients with Renal biopsy, According to the age and sex of the patients and the results of clinical examination, the severity of renal pathological changes was preliminarily inferred, the further treatment was guided, and the prognosis was judged for the patients who could not carry out renal biopsy in hospitals or patients with contraindication of renal puncture. Conclusion: the pathological type of basic kidney disease in nephrotic syndrome determines its prognosis. PNSs are still the main body of renal disease. The incidence of membranous nephropathy is the highest. The secondary nephrotic syndrome (SNS) is mainly atypical membranous nephropathy. Renal biopsy is of great significance in the diagnosis, treatment and prognosis of renal diseases. The significance of diagnosis and treatment combined with pathology is higher than that of clinical diagnosis and treatment alone.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692

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