摘要
目的探讨不同病理类型局灶节段性肾小球硬化症（FSGS）的临床病理特征及其与临床表现的关系。方法对北京大学第一医院2000年1月—2005年12月收集的102例特发性FSGS进行回顾性病理阅片及分型，并对其活动性及慢性化病理改变进行定量评估，分析不同病理类型FSGS的病理变化及其临床表现的特征。结果102例FSGS中，非特殊型占55．9％，门部型占6．9％，细胞型占25．5％，顶端型占4．8％，塌陷型占6．9％。细胞型和顶端型FSGS的尿蛋白水平较非特殊型明显增高，塌陷型和顶端型FSGS的肾病综合征比例较其他三型明显升高（x^2=12．23，P＜0．05），细胞型和塌陷型FSGS的病理活动性积分较其他3型明显增高（P＜0．05）；门部型FSGS的病程较其他4组患者明显增高，其病理慢性化积分较顶端型和非特殊型明显增高（P＜0．05）；顶端型FSGS的病理总积分最少，明显低于细胞型和塌陷型（P＜0．05）；其慢性化积分较非特殊型和门部型明显降低（P＜0．05）。结论非特殊型FSGS是特发性FSGS的主要病理类型；塌陷型和细胞型FSGS是病变处于活动性阶段的病理类型，门部型FSGS为病理改变呈慢性化的病理类型，顶端型FSGS是病理改变最轻的病理类型。
Objective To study the clinicopathologic features of different variants of primary focal segmental glomernlosclerosis （FSGS）. Methods One hundred and two cases of FSGS were retrieved from the archival files of Peking University First Hospital during the past 6-year period. The pathologic findings were reviewed and the degrees of active and chronic changes were assessed by morphometric analysis. The histopathologic patterns were then correlated with clinical manifestations. Results Amongst the 102 cases of primary FSGS studied, 55.9% belonged to the NOS （ not other specified ） variant, while the perihilar, cellular, tip and collapsing variants accounted for 6.9% , 25.5% , 4.8% and 6.9% respectively. The level of proteinuria in the cellular and tip variants were much higher than that in the NOS variant; and the incidence of nephrotic syndrome in the tip and collapsing variants was higher than that in the other three variants （X^2 = 12. 23, P 〈0. 05）. The activity score of the cellular and collapsing variants was also higher than that of the other three variants （ P 〈 0. 05 ）. The interval between disease onset and renal biopsy diagnosis in the perihilar variant was longer than that in the other variants. The chronicity score of this variant was higher than that of the tip and NOS variants （ P 〈 0.05 ）. On the other hand, the total scores of active and chronic changes of the tip variant was lower than that of the cellular and collapsing variants （ P 〈 0.05 ） ; and its chronic score was lower than that of the NOS and perihilar variants （ P 〈 0. 05 ）. Condusions The NOS variant is the commonest morphologic pattern seen in primary FSGS. The cellular and collapsing variants are the patterns associated with active lesions, while perihilar variant is the pattern associated with chronic lesions. The tip variant shows mild pathological changes compared with the other patterns.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2007年第1期11-14,共4页
Chinese Journal of Pathology
