[肾移植术后临床诊断与组织学诊断的比较]
[Comparison of clinical and histological diagnosis in kidney post-transplantation period].
作者信息
de Castro M C, Chocair P R, Saldanha L B, Nahas W, Arap S, Sabbaga E, Ianhez L E
机构信息
Unidade de Transplante Renal, Faculdade de Medicina, Universidade de São Paulo.
出版信息
Rev Assoc Med Bras (1992). 1998 Apr-Jun;44(2):155-8.
PURPOSE
To assess the agreement between clinical and histopathological diagnosis in a renal transplantation center, 40 episodes of acute renal failure were studied.
METHODS
Kidney biopsies were performed at the moment that a clinical diagnosis was made by the staff.
RESULTS
Nineteen episodes of acute tubular necrosis (ATN), eighteen episodes of acute cellular rejection (ACR), 2 humoral rejections and 1 acute cyclosporin nephrotoxicity episodes were diagnosed. ATN episodes were confirmed by renal biopsy in 84.21%, ACR episodes in 83.33%, humoral rejections in 100%. Renal biopsy showed ATN in the occurrence of clinical cyclosporin nephrotoxicity. Total agreement was 82.5%.
CONCLUSION
There is a good relationship between clinical and histopathological diagnosis in the post-transplantation period. Diagnostic mistakes occurred mainly when oliguria was present.
目的
为评估一家肾移植中心临床诊断与组织病理学诊断之间的一致性，对40例急性肾衰竭病例进行了研究。
方法
在工作人员做出临床诊断时进行肾活检。
结果
诊断出19例急性肾小管坏死（ATN）、18例急性细胞性排斥反应（ACR）、2例体液性排斥反应和1例急性环孢素肾毒性病例。肾活检确诊ATN病例占84.21%，ACR病例占83.33%，体液性排斥反应病例占100%。肾活检显示临床环孢素肾毒性病例中存在ATN。总体一致性为82.5%。
结论
移植后期临床诊断与组织病理学诊断之间存在良好的相关性。诊断错误主要发生在少尿存在时。
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