电镜检查在肾小球疾病病理诊断中的价值研究-现代医学

电镜检查在肾小球疾病病理诊断中的价值研究

单位：东南大学肾脏病研究所/东南大学附属中大医院, 江苏南京 210009

分类号：R692.6;R361.3

出版年·卷·期（页码）：2018·46·第五期（477-483）

摘要：

目的：分析电镜检查在肾小球疾病病理诊断中的价值。方法：选取2016年5月至2017年5月282例临床肾活检标本，将电镜对肾小球疾病的诊断分为决定性诊断、辅助诊断、无诊断作用3类，以评估电镜在肾小球疾病中的诊断价值。结果：电镜检查对病理诊断起决定性作用48例，占全部病例的17.02%，依赖电镜检查得以确诊；对病理诊断起参考和辅助作用159例，占56.38%；电镜对病理诊断没有帮助75例，占26.60%。结论：电镜检查在肾小球疾病病理诊断中具有重要作用。

Objective: To analyze the necessity of electron microscopy for the diagnosis of glomerulopathies.Methods: 282 cases of renal biopsy from May 2016-May 2017 with some clinical data were retrospectively reviewed. The contribution of electron microscopy to the final diagnosis was graded as necessary(diagnosis could not be reached without it), supportive(it increased the level of confidence in the final diagnosis) and noncontributory(the diagnosis didn't need electron microscopy).Results: The contribution of electron microscopy to the final diagnosis was necessary in 48 cases(17.02%), supportive in 159 cases(56.38%) and noncontributory in 75 cases(26.60%).Conclusion: Electron microscopy still remains an important tool in diagnosis of glomerulopathies.

参考文献：

[1] HASS M.A reevaluation of routine electron microscopy in the examination of native renal biopsies[J].J Am Soc Nephrol,1997,8(1):70-76.
[2] 竺培青,朱光华,何威逊,等.电镜在肾小球疾病病理诊断中的价值[J].临床儿科杂志,2007,25(4):278-281.
[3] 黄朝兴,吕吟秋,方周溪.透射电镜检查在肾小球疾病病理诊断中的作用[J].温州医学院学报,2002,32(2):10-12.
[4] 杜园园,黄朝兴.足突融合与IgA肾病肾小球硬化及蛋白尿的相关性分析[J].温州医学院学报,2007,37(3):247-249.
[5] DEEGENS J K,DIJKMAN H B,BORM G F,et al.Podocyte foot process effacement as a diagnostic tool in focal segmental glomerulosclerosis[J].Kidney Int,2008,74(12):1568-1576.
[6] A Working Group of the International IgA Nephropathy Network and the Renal Pathology Society, ROBERTS I S,COOK H T,et al.The Oxford classification of IgA nephropathy:pathology definitions,correlations,and reproducibility[J].Kidney Int,2009,76(5):546-556.
[7] 黎磊石,刘志红.中国肾脏病学[M].北京:人民军医出版社,2008:164-166.
[8] HERRERA G A,TURBAT-HERRERA E A.Renal disease with organized deposits.An algorithmic approach to classiflcation and clinicopathologic diagnosis[J].Arch Path lab Med,2010,134(4):512-531.
[9] COLVIN R B.Kidney diseases[M].2nd Ed.Canda:Amirsys,2011:260-261.
[10] 宋志霞,郭银凤,周敏,等.活性维生素D3通过抑制TRPC6表达发挥糖尿病肾病的保护作用[J].东南大学学报(医学版),2014,33(6):683-690.
[11] HARA S,TSUKAGUCHI H,OKA T,et al.Monoclonal immunoglobulin associated proliferative glomerulonephritis characterized by organized deposits of striated ultra-substructures:a case report[J].Ultrastruct Pathol,2017,41(4):301-307.
[12] BROWN L C,JOBSON M A,PAYAN SCHOBER F,et al.The evolving role of rituximab in adult minimal change glomerulopathy[J].Am J Nephrol,2017,45(4):365-372.
[13] 丁洁.Alport综合征的诊断[J].肾脏病与透析肾移植杂志,2010,19(4):344-345.
[14] CHEN Y,COLVILLE D,IERINO F,et al.Temporal retinal thinning and the diagnosis of Alport syndrome and thin basement membrane nephropathy[J].Ophthalmic Genet,2017,27:1-7.
[15] KASHTAN C.Alport syndrome:facts and opinions[J].F1000Res,2017,6:50.
[16] 王连有,陈桂秋,翟天姝.电镜对肾小球疾病的病理诊断[J].中国实验诊断学,2013,17(8):1551-1552.
[17] 曲利娟,余英豪,余毅,等.电子致密物沉积病的超微结构观察[J].电子显微学报,2002,21(6):879-884.
[18] TRIMARCHI H,BARRATT J,CATTRAN D C,et al.Oxford classification of IgA nephropathy 2016:an update from the IgA Nephropathy Classification Working Group[J].Kidney Int,2017,91(5):1014-1021.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录