肾病综合征临床病理与预后的探讨Clinical Pathology and Prognosis of 45 Cases of Nephronic Syndrome
朱春玲,陈运芬,彭红英,陈佳
ZHU Chun ling 1; CHEN Yun fen 1; PENG Hong ying 1; CHEN Jia 2 (1.Department of Nephrology Medicine;
摘要(Abstract):
目的 :研究 4 5例肾病综合征 (NS)患者的病理改变及临床经过 ,探讨NS的预后。方法 :4 5例NS患者均作肾穿刺活检 ,分别做普通光镜及免疫荧光检查 ,据其病理类型制定不同的治疗方法 ,判断疗效 ,并追踪观察。结果 :原发性NS系膜增生 (MePGN)有效率 80 % ,局灶增生性 (FPGN) 5 0 % ;在慢性肾小球肾炎 (CGN )MePGN有效率 80 % ,局灶节段性硬化性肾小球肾炎 (FSGS)有效率 5 0 % ;狼疮性肾炎 (LN )MePGN有效率10 0 % ;新月体肾炎 (CreGN)有效率 33 3%。结论 :轻、中度MePGN、Ⅰ期膜性肾病 (MN)、FPGN的疗效及预后较好 ;重度MePGN、膜增生性肾小球肾炎 (MPGN)、FSGS、Ⅱ期MN疗效及预后较差 ,骁悉 (MMF)可改善其预后。CreGN虽为细胞新月体时 ,若肾小管、间质慢性病变较重 ,预后亦差
Objective: To investigate the prognosis of nephronic syndrome (NS) through pathological study and clinical observation on 45 cases of NS. Methods: Renal biopsy and following checks with routine pathological sections and immunofluorescence examinations were carried out on all of the 45 cases of NS. Different treatment plans were made for these patients according to the pathological classification, and the curative results were observed. Results: The effective rates of primary NS were: membrane proliferative glomerulonephritis (MePGN) 80%, focal proliferative glomerulonephritis (FPGN) 50%, chronic MePGN (CGN MePGN) 80%, focal segmental sclerosis (FSGS) 50%, lupous NS with membrane proliferation (LN) MePGN 100%, and crescent glomerulonephritis (CreGN) 33.3%. Conclusion: The curative results and prognosis of mild and middlely severe MePGN, and phase Ⅰ membrane nephritis (MN) were relatively good. That of severe MePGN, MPGN, FSGS, phase Ⅱ MN, and FPGN were not as good. Although CreGN is crescent, the chronic lesion of renal tubules and the interrenal tissue is severe. The prognosis of it is not good.
关键词(KeyWords):
肾病综合征;病理学,临床;预后
nephrotic syndrome; pathology,clinical; prognosis
基金项目(Foundation):
作者(Authors):
朱春玲,陈运芬,彭红英,陈佳
ZHU Chun ling 1; CHEN Yun fen 1; PENG Hong ying 1; CHEN Jia 2 (1.Department of Nephrology Medicine;
DOI: 10.19367/j.cnki.1000-2707.2003.03.016
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