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[膜性肾病——在热舒夫市圣雅德维加临床二区医院内科、肾病与内分泌科接受肾活检的患者中最常诊断出的肾小球病]

[Membranous nephropathy - the most commonly diagnosed glomerulopathy in patients who underwent renal biopsy in the Department of Internal Medicine, Nephrology and Endocrinology St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszow].

作者信息

Kołodziej-Kłęk Aneta, Gala-Błądzińska Agnieszka, Okoń Krzysztof, Sadowska Agnieszka, Świder Grzegorz

出版信息

Przegl Lek. 2017;74(2):76-80.

Abstract

We retrospectively analysed the results of 120 renal biopsy, performed in 52 women, 62 men and 6 children hospitalized mainly in the Department of Internal Medicine, Nephrology and Endocrinology St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszów from 2013 to 2016. The average age of patients on whom renal biopsy was performed amounts to 44 (7-78) years. The most common indications for renal biopsy were nephrotic syndrome in 47 patients (37.3%), non-nephrotic proteinuria in 31 patients (24.6%), worsening renal function in 22 patients (17.5%), coexistence proteinuria with hematuria in 16 patients (12.7%), nephritic syndrome in 9 patients (7.1%) as well as an isolated hematuria in 1 patient (0.8%). Membranous glomerulonephritis was the most common histological diagnosis observed in biopsies, and was diagnosed in 19 patients (15.1%). In 14 patients we diagnosed lupus nephritis (11.1%). With the same frequency we diagnosed focal glomerulosclerosis, and mesangioproliferative glomerulonephritis (11 patients, 8,7%). Membraneproliferative glomerulonephritis was diagnosed in 10 patients (7.9%). Other nephropathy accounted for less than 8% of all diagnoses. Most patients with membranous nephropathy (8 patients, 61%) had antibodies against phospholipase A2 receptor. All patients with a diagnosis of membranous nephropathy received the renin- angiotensin-aldosterone system blockade, and 13 patients (68.4%) received immunosuppressive therapy. Complete remission was achieved in 11 patients (64.7%) with primary membranous nephropathy. In 35 patients (27.8%) of all patients who underwent renal biopsy they had complications after procedure in the form of small and clinically insignificant perirenal hematomas. Hematuria was observed in 7 cases (5.56%). In one case, due to retroperitoneal bleeding, the patient required a transfusion of blood products.

摘要

我们回顾性分析了2013年至2016年期间在热舒夫市圣雅德维加临床二区医院内科、肾病科和内分泌科住院的52名女性、62名男性和6名儿童所进行的120例肾活检结果。接受肾活检患者的平均年龄为44(7 - 78)岁。肾活检最常见的指征为47例(37.3%)肾病综合征、31例(24.6%)非肾病性蛋白尿、22例(17.5%)肾功能恶化、16例(12.7%)蛋白尿合并血尿、9例(7.1%)肾炎综合征以及1例(0.8%)孤立性血尿。膜性肾小球肾炎是活检中最常见的组织学诊断,19例(15.1%)患者被诊断为此病。14例(11.1%)患者被诊断为狼疮性肾炎。局灶性肾小球硬化和系膜增生性肾小球肾炎的诊断频率相同(11例,8.7%)。10例(7.9%)患者被诊断为膜增生性肾小球肾炎。其他肾病占所有诊断的比例不到8%。大多数膜性肾病患者(8例,61%)有抗磷脂酶A2受体抗体。所有诊断为膜性肾病的患者均接受了肾素 - 血管紧张素 - 醛固酮系统阻滞剂治疗,13例(68.4%)患者接受了免疫抑制治疗。11例(64.7%)原发性膜性肾病患者实现了完全缓解。在所有接受肾活检的患者中,35例(27.8%)术后出现并发症,表现为小的、临床上无显著意义的肾周血肿。7例(5.56%)出现血尿。1例患者因腹膜后出血需要输注血液制品。

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