本文選題：腎活檢　切入點(diǎn)：腎小球疾病　出處：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：分析我院610例行腎穿刺活檢的患者的性別、年齡、病理類型及臨床表現(xiàn),為疾病的診治提供有價(jià)值的資料。 方法：收集2004年1月～2014年1月于大連醫(yī)科大學(xué)附屬第二醫(yī)院住院的610例行腎活檢的患者的臨床表現(xiàn)、實(shí)驗(yàn)室檢查等資料，參照WHO1982年及改良的1995年腎小球疾病組織學(xué)分型修訂方案,結(jié)合臨床資料、實(shí)驗(yàn)室檢查結(jié)果及腎臟病理明確診斷，對(duì)患者的年齡、性別及原發(fā)病的構(gòu)成、腎臟病理類型進(jìn)行統(tǒng)計(jì)，，并比較我院2004年1月～2014年1月前后5年腎臟病理類型的變化。 結(jié)果:1.共收集610例患者，原發(fā)性腎小球疾病（PGD）468例占（76.72%）,繼發(fā)性腎小球疾病(SGN)142例占（23.28%），PGD中IgA腎病(IgAN)占（32.69%），其次分別為膜性腎病(MN)占（27.99%），系膜增生性腎小球腎炎腎炎(MsPGN)(26.06%);SGN中最常見的3種疾病依次為:乙肝病毒相關(guān)性腎小球腎炎占（35.91%）,狼瘡性腎炎占（26.76%）,過敏性紫癜性腎炎占（24.64%）。 2.性別分布特點(diǎn)：男性306例占(50.16%),女性304例占(49.84%)。在PGD中男性248例占（52.99%），女性220例占（47.01%），在SGN中，男性58例占（40.85%），女性84例占（59.15%），原發(fā)性腎小球疾病和繼發(fā)性腎小球疾病男女分布有顯著差異（P0.01）。 3.年齡分布特點(diǎn)：原發(fā)性腎小球疾病在25～34歲年齡組所占比例最高,IgAN、MsPGN和局灶節(jié)段腎小球硬化（FSGS）3種在25～34歲年齡組所占比例最高；MN在55～64歲年齡組所占比例明顯高于另外5種病理類型。繼發(fā)性腎小球疾病中以35～44歲年齡組發(fā)病最多.狼瘡性腎炎在25～34歲年齡組所占比例最高；過敏性紫癜性腎炎在14～34歲年齡組所占比例最高；乙肝病毒相關(guān)性腎炎則以35～44歲年齡組所占比例最高。 4.分析前后5年間原發(fā)性腎小球腎炎病理改變，存在統(tǒng)計(jì)學(xué)意義（P0.01）,2009～2014年間MN檢出率提高明顯，與其他病理類型比較存在統(tǒng)計(jì)學(xué)意義（P0.05）。而繼發(fā)性腎小球疾病病因變化從總體上看無(wú)顯著統(tǒng)計(jì)學(xué)意義（P0.05）。 5.病理類型及臨床表現(xiàn)關(guān)系，本組患者腎病綜合征(NS)(44.10%)最為常見，其次是腎炎綜合征(GH)(39.20%)、慢性腎功能衰竭(14.60%)、急性腎功能衰竭(ARF)(1.80%)、隱匿性腎小球腎炎（0.30%）。 結(jié)論：1.原發(fā)性腎小球疾病是最常見的腎小球疾病,其中IgA腎病所占比例最高,膜性腎病發(fā)病率升高；乙肝病毒相關(guān)性腎炎是繼發(fā)性腎小球腎炎最常見的病因。 2.青壯年為腎小球腎炎的高發(fā)人群，繼發(fā)性腎小球疾病男女比例存在明顯差異,并且以女性占優(yōu)勢(shì)。 3.腎病綜合癥是最常見的臨床分型。
[Abstract]:Objective: to analyze the sex, age, pathological type and clinical manifestation of 610 cases of renal biopsy in our hospital, and to provide valuable data for diagnosis and treatment of the disease.Methods: from January 2004 to January 2014, 610 cases of renal biopsy were collected from the second affiliated Hospital of Dalian Medical University.According to the revised histological classification scheme of glomerular diseases in WHO1982 year and modified 1995, combined with clinical data, laboratory results and renal pathology, the age, sex, constitution of primary disease and renal pathological type were statistically analyzed.The changes of renal pathological types in our hospital from January 2004 to January 2014 were compared.The result is 1: 1.A total of 610 patients were collected.Liver virus-associated glomerulonephritis accounted for 35.91%, lupus nephritis 26.76%, Henoch-Schonlein purpura nephritis 24.64%.2.Sex distribution: 306 cases of males and 304 cases of females accounted for 50.16% and 49.84% respectively.In PGD, there were 248 males (52.99g) and 220 females (47.01%). In SGN, 58 males (40.85%) and 84 females (59.1515%) had significant differences in the distribution of primary glomerular diseases and secondary glomerular diseases (P 0.01).3.Age distribution: the proportion of primary glomerular diseases in the age group of 25 to 34 years old was the highest, and the proportion of IgANMsPGN and FSGSN in the age group of 25 to 34 years old was the highest. The proportion of MN in the age group of 55 to 64 years old was significantly higher than that of the other five pathological types.The incidence of secondary glomerular diseases was the highest in the age group of 35 to 44 years old.The proportion of lupus nephritis was the highest in the age group of 25 ~ 34 years old, the proportion of Henoch-Schonlein purpura nephritis group was the highest in the age group of 14 ~ 34 years, and the proportion of hepatitis B virus associated glomerulonephritis group was the highest in the age group of 35 ~ 44 years old.4.The pathological changes of primary glomerulonephritis in the five years before and after analysis showed that the detection rate of MN increased significantly between 2009 and 2014, and there was statistical significance compared with other pathological types.The etiological changes of secondary glomerular diseases were not statistically significant (P 0.05).5.The pathological types and clinical manifestations were most common in this group of patients with nephrotic syndrome (NS44.10), followed by glomerulonephritis syndrome (GHN) 39.20%, chronic renal failure (CRF) 14.60%, acute renal failure (ARFN) 1.80%, occult glomerulonephritis (0.30).Conclusion 1.Primary glomerular disease is the most common glomerular disease in which IgA nephropathy accounts for the highest incidence of membranous nephropathy and hepatitis B virus associated glomerulonephritis is the most common cause of secondary glomerulonephritis.2.The male and female ratio of secondary glomerulonephritis was significantly different in the young and adult population with high incidence of glomerulonephritis.3.Nephrotic syndrome is the most common clinical classification.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692

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