【摘要】 目的:探讨隐匿性肾小球肾炎患者的临床特点与肾脏病理情况,为临床治疗提供依据。方法:选取隐匿性肾小球肾炎患者121例,行肾穿刺活检术,分析肾脏病理特点。结果:临床表现为单纯血尿51例(42.15%),同时存在血尿和蛋白尿(尿蛋白定量<1.0 g/d)70例(57.85%);病理表现为Ig A肾病56例(46.28%),非IgA肾病系膜增生性肾小球肾炎38例(31.41%),局灶性节段性肾小球硬化症11例(9.10%),轻微病变9例(7.44%),Ig M肾病4例(3.31%),乙型肝炎病毒相关性肾炎3例(2.48%)。肾小球病理评分:0级为3例(2.48%);1级75例(61.98%),2级38例(31.41%),3级5例(4.13%);肾小管病理评分:0级4例(3.31%),1级69例(57.02%),2级41例(33.89%),3级7例(5.78%)。单纯血尿组其肾小球及肾小管病理损伤评分均低于血尿并蛋白尿组(P<0.05)。结论:隐匿性肾小球肾炎患者病理改变多样,以Ig A肾病多见,其病理改变并非都轻;血尿程度和病理改变程度无相关,轻度蛋白尿和病理损害明显相关;及时行肾穿刺活检有助于早期发现偏重病理改变并及时治疗。更多还原

【Abstract】 Objective: To investigate the clinical feature and renal pathological behavior in patients with asymptomatic glomerular hematuria. Methods: 121patients with asymptomatic glomerular hematuria were collected from the inpatients that were diagnosed with primary chronic glomerulonehpritis. The clinical and pathological features of patients were analyzed. Results: Among these patients 51 cases(42.15 %) were categorized as pure hematuria,70 Cases(57.85 %) were hematuria companied by proteinuria.Distributions of renal pathologcial type were:immunoglobulin A nephropathy 46.28 %,mesangial proliferative glomerulonephoritis 31.41%,focal segmental glomerulonephritis 9.10 %,minor glomerulonephritis 7.44 %, immunoglobulin M nephropathy 3.31%, hepatitis B virus associated glomerulonephritis 2,48 %.The renal counting scores in 121 patients were normal in 3 cases(2.48 %),showed mild lesions in 75 cases(61.98 %),moderate ldsions in 38 cases(31.41%),and severe lesion in cases(7 %).The counting scores of the tubulointerstitial lesions showed normal in 4 cases (3.31%), mild lesions in 69 cases (57.02 %), moderate lesions in 41 cases(33.89%), and severe lesions in 7 cases(5.78 %). Conclusions: There were various pathologic changes in patients with glomerular hematuria, IgA N is more common. Patients with asymptomatic glomerular hematuria do not always present with mild pathologic lesions. There was no significant relationship between the severity of hematuria and the renal pathological type, but mild proteinuria is also associated with the severity of renal pathologic lesion. Early treatment and long term follow-up is important for those patients who follow a course of chronic progressive renal disease.更多还原