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《狼疮性肾炎肾穿刺活检112例临床病理分析.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、诊断病理学杂志2013年12月第20卷第l2期·763·doi:10.3969/j.issn.1007-8096.2013.12.008狼疮性肾炎肾穿刺活检112例临床病理分析隋燕霞,孙涛,杨拮,李晓锋,王鸿雁,张冠军(西安交通大学医学院1.第一附属医院病理科;2.药理系,西安710061)[摘要]目的探讨狼疮性肾炎(IJN)的临床病理特点。方法回顾性分析112例狼疮性肾炎的临床及肾穿刺活检标本的病理特征与分型的关系。结果112例中女性99例,男性13例。年龄5—69岁,平均(31.8±11.5)岁。I的病理形态多种多样,肾小球可表现为系膜增生、毛细
2、血管内增生、膜增生、基底膜增厚、纤维素样坏死、新月体形成、肾小球硬化;肾小管可有不同程度的变性、坏死;间质可有炎细胞浸润及纤维化。按国际肾病学会和肾脏病理学会工作组LN(2003)的病理分类方案,分为8型。112例LN的分型为I型1例,轻微病变性LN;Ⅱ型12例,系膜增生性LN;Ⅲ型17例,局灶性LN;IV型38例,弥漫性LN;V型15例,为膜性LN;m+V型8例,为Ⅲ型合并V型的LN;IV+V型2O例,为Ⅳ合并V的LN;VI型1例,为严重硬化性LN。病理类型以Ⅳ型最常见。结论肾组织活检病理学诊断是确诊狼疮性肾炎的可靠方法,可以为临床的治疗及判断预后
3、提供可靠的形态学依据。[关键词】狼疮性肾炎;。肾活检;病理学[中图分类号]R732.2[文献标识码】A[文章编号]1007—8096(2013)12—0763—04Lupusnephritis:aclinicopathologicalanalysisof112renalbiopsycasesSUIYon-)【in,SUNTao,YANGZhe,LIXiuo.feng。,WANGHong.yon,ZHANGGuon-jun(1.DepartmentofPathology,The瑙£AffiliatedHospitalofXi’anJiaotongUni
4、versityCollegeofMedicine,Xi’an710061,China;2.DepartmentofPharmacology,Xi’anJiaotongUniversityCol~geofMedicine,Xi’an710061,China)Abstract:ObjectiveToevaluatetheclinic叩atholocalcharacteristicsofthelupusneghritis(LN).MethodsTheclinicalandkidneypuncturebiopsydatawereassessedandther
5、elationshipbetweenclinicalcharacteristicsandpathologicaltypeswereretrospectivelyanalyzedin112renalbiopsycases.ResultsInthe112patients,99werefemale,while13weremale.Theageofpatientswasfrom5to69years.andtheaverageagewas31.83±11.54years.ThepathologicalpatternsofLNwerevarious:thepat
6、hologicalchangesinglomerulusshowedmesangialproliferation,endocapillaryproliferation,membraneproliferation,thickeningofbasementmembrane,fibrinoidnecrosis,crescentformationandglomerularsclerosis,andthepathologicalchangesinrenaltubulesdisplayeddiferentdegreesofdeformationandnecros
7、is,whileinflammatorycellsinfiltrationandfibrosiswerealsofoundininterstition.Allthecasesererdividedinto8typesaccordingtopathologicalclassificationofLN(2003).Thepathologicaltupesofthe112casesofLNshowedasfollows:1caseoftype1wasslightpathologicalchangesofLN,12casesoftypeI/weremesan
8、gioproliferativeLN,17casesoftypemwerefocalLN,38casesof
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