摘要
目的探讨西北地区老年患者肾脏病的流行病学特点，临床、病理表现及性别间的差别。方法回顾分析我院近20年肾活检且资料完整559例老年患者的临床病理资料。结果（1）559例患者中，男性347例（62．1％），女性212例（37．9％）；年龄60-84岁，平均（66．7±5．3）岁；肾活检时病程的中位数为5．0个月；（2）原发性肾小球疾病69．6％（389／559），继发性肾小球疾病占25．4％（142／559），小管及间质性疾病3．7％（21／559），其他1．3％（7／559）；（3）原发性肾小球疾病的临床表现以肾病综合征最多见（60．7％），其次为慢性肾小球肾炎（31．6％），病理类型以膜性肾病最常见（34．5％），其次为系膜增生性肾小球肾炎（32．4％）；（4）继发性肾小球疾病共142例，常见疾病依次为原发性小血管炎35例（24.7）％，糖尿病肾病28例（19．7％），肾淀粉样变性19例（13．4％），系统性红斑狼疮肾炎15例（10．6％），其中系统性红斑性狼疮性肾炎女性多于男性（P〈0．05）；（5）引起急、慢性肾功能不全的常见原发性肾小球疾病分别是肾病综合征及慢性肾小球肾炎；引起急、慢性肾功能不全的常见继发性肾小球疾病分别是原发小血管炎及糖尿病肾病。结论（1）本组患者男性多于女性，系统性红斑狼疮性肾炎女性多于男性；（2）原发性肾小球疾病最多，病理类型以膜性肾病及系膜增生性肾小球肾炎为主；（3）常见的继发性肾脏损害疾病为原发性小血管炎肾损害及糖尿病肾病；（4）引起肾功能不全常见病理类型为系膜增生性肾小球肾炎，引起急性肾功能不全常见疾病为肾病综合征、原发性小血管炎，引起慢性肾功能不全常见疾病是慢性肾炎及糖尿病肾病。
Objective To study the epidemiology, pathologies and clinical manifestations of renal diseases in elderly patients of different genders in China northwest region. Methods Retrospective analysis was used to evaluate the clinical and pathological informations of patients above 60 years old who underwent renal biopsy and had the integrated data in the past 20 years. Results （1）Among the 559 patients, there were 347 men accounting for 62.1%, and there were 212 women accounting for 37.9% the average age was （66.7±5.3）years, the median course of disease was 5.0 months when receiving renal biopsy, and 50% cases was （1.3 - 12.0）months. （2） Primary glomerulopathy accounted for 69.59 % （389/559）, secondary glomerulopathy, tubulointerstitial disease and the others accounted for 25.4% （142/559）, 3.8% （21/559） and 1.3%（7/559）, respectively. （3） According to clinical manifestation, nephrotic syndrome was the most common disease（accounting for 60. 7%）,and then chronic glomerulonephritis accounted for 31.6% .In pathology, membranous nephropathy was the most frequently category accounting for 34.5%, then mesangial proliferative glomerulonephritis accounted for 32.4%. （4） Among secondary glomerulopathy, the frequent diseases were primary polyangitis, diabetic nephropathy, amyloidosis of kidney and lupus nephritis, accounting for 24. 7%,19.7 %, 13.4 % and 10.6%, respectively, and the number of women was more than men in lupus nephritis （P〈0.05）. （5） The common diseases of primary glomerulopathy that would result in renal insufficiency were nephrotic syndrome and chronic glomerulonephritis, accounting for 76.5% （ 26 / 34） and 76.2 % （48 / 63）, respectively, and the common pathological type was both mesangial proliferative glomerulonephritis. The common diseases of secondary glomerulopathy that would result in renal insufficiency were primary small vessel vasculitis and diabetic nephropathy, accounting for 46.3%（19/41）and 34.4%（11/32）,respectively. Conclusions （
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第1期73-76,共4页
Chinese Journal of Geriatrics
