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Received:March 28, 2022 Published Online:January 20, 2023
Received:March 28, 2022 Published Online:January 20, 2023
中文摘要: 目的探讨鲁北地区单中心近10年经皮肾穿刺活检（以下简称肾活检）肾脏病患者的流行病学与肾脏病理特征疾病谱的变化。
方法回顾性分析2010年1月至2019年12月就诊于滨州医学院附属医院并行肾活检的2407例患者的临床资料与病理资料。根据5年为时间段和年龄段分组，分析10年间鲁北地区肾脏疾病谱的变化。
〖JP+1〗结果（1）基本资料：共纳入2407例肾活检肾脏病患者，年龄（43.90±15.47）岁，男∶女为1∶0.77，最常见的病理类型是膜性肾病865例（35.9%）。（2）最常见的原发性和继发性肾小球疾病病理类型的时间分布：在前5年组（2010—2014年）中分别为IgA肾病、狼疮肾炎，在后5年组（2015—2019年）中分别为膜性肾病、糖尿病肾病;后5年组中膜性肾病、糖尿病肾病、高血压肾病占比明显高于前5年组（P＜0.05）。（3）最常见的原发性和继发性肾小球疾病病理类型的年龄分布：在未成年组（＜18岁，n=88）中分别为微小病变型肾病（15例，25.86%）、过敏性紫癜性肾炎（23例，79.31%）；在青年组（18～44岁，n=1090）中分别为IgA肾病358例（42.12%）、狼疮肾炎（67例，30.45%）；在中年组（45～59岁，n=800）中分别为膜性肾病（376例，59.68%）、糖尿病肾病（42例，29.17%）；在老年组（≥60岁，n=429）中分别为膜性肾病（178例，56.69%）、糖尿病肾病（37例，35.63%）;其中老年组每年经皮肾穿刺活检人数呈逐年递增趋势。
结论鲁北地区单中心近10年肾活检肾脏病患者，男性比例高于女性，以原发性肾小球疾病最为常见，最常见的原发性和继发性肾小球疾病病理类型分别为膜性肾病、狼疮肾炎。未成年、青年、中老年患者最常见的原发性和继发性肾小球疾病病理类型分别为微小病变型肾病和过敏性紫癜性肾炎，IgA肾病和狼疮肾炎以及膜性肾病和糖尿病肾病。
中文关键词: 肾活检 原发性肾小球疾病 继发性肾小球疾病 膜性肾病；狼疮肾炎；糖尿病肾病；高血压肾病
Abstract:ObjectiveTo investigate the epidemiological and renal pathological characteristics in kidney disease patients with percutaneous renal biopsy（PRB） in a single center of Northern Shandong Province in the past 10 years.
MethodsA retrospective analysis was made on the clinical and pathological data of 2407 patients with kidney disease undergoing PRB in Binzhou Medical University Hospital from January 2010 to December 2019. The patients were grouped based on the 5 year period and the age to analyze the changes of the kidney disease spectrum in Northern Shandong during the 10 year period.
Results The age of the patients was（43.90±15.47） years old. The ratio of male to female was 1∶0.77. The most common pathological type was membranous nephropathy（MN）（865 cases, 35.9%）. Time distribution of the most common pathological types of primary glomerular diseases (PGD) and secondary glomerular diseases(SGD): there were IgA nephropathy(IgAN) and lupus nephritis(LN) in the first 5 year group (2010-2014), and MN and diabetic nephropathy(DN) in the latter 5 year group (2015-2019). The proportion of MN, DN and hypertensive nephropathy in the latter 5 year group was significantly higher than that in the former 5 year group (P<0.05).
Age distribution of the most common pathological types of PGD and SGD: in the juvenile group（＜18 years old, n=88）, there were minimal change nephropathy（MCD）（n=15, 25.86%） and allergic purpura nephritis（HSPN）（n=23, 79.31%）; in the youth group（18-44 years old, n=1090）, there were 358 cases of IgAN（42.12%） and 67 cases of LN（30.45%）; in the middle aged group（45-59 years old, n=800）, there were 376 cases of MN（59.68%） and 42 cases of DN（29.17%）; in the elderly group（≥60 years old, n=429）, there were 178 cases of MN（56.69%） and 37 cases of DN（35.63%）. Among them, the number of patients undergoing PRB increased year by year.
Conclusion In the past 10 years in a single center in Northern Shandong, the proportion of male patients with renal diseases by PRB is higher than that of female patients. PGD is the most common,with the most common pathological types of MN and LN for PGD and SGD. The most common pathological types of PGD and SGD are MCD and HSPN in juvenile patients, IgAN and LN in young patients and MN and DN in middle aged and elderly patients, respectively.
keywords: Renalbiopsy Primaryglomerulardisease Secondaryglomerulardisease Membranousnephropathy Lupusnephritis Diabeticnephropathy Hypertensivenephropathy
文章编号： 中图分类号：R181.3+2 文献标志码：A
基金项目:国家自然科学基金（81670620）;山东省自然科学基金（ZR2020MH080）;山东省医药卫生科技发展计划项目（2017WS689）;大学生创新创业训练计划项目（X202110440283）;滨州医学院附属医院科研计划项目（BY2021KJ07）
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