CAJ | 학술논문

目的总结本中心移植肾活检的病理学类型、特点和治疗效果.方法回顾性分析本院2004年2月～2007年11月共117 例移植肾穿刺活检的病理学资料.根据Banff97 移植肾活检病理学诊断与分类方案,结合患者的病史和临床表现制定相应的治疗策略,并对治疗效果进行随访研究.结果 117例移植肾穿刺活检标本的病理类型为:急性排斥反应共68 例,占58.1%;慢性移植物肾病20 例(17.1%);临界性病变11例(9.4%);CNI药物中毒4例(3.4%);急性肾小管坏死3例(2.6%);其他包括正常和无法确诊共11例(9.4%).经治疗后,急性肾小管坏死和药物中毒的患者全部好转.11 例临界性病变的患者,治疗有效率为81.8%.慢性移植物肾病的20 例患者,治疗后15 理例(75%)好转.三个时间段急性排斥(O～3 个月、3～12 个月和大于12 个月)的治疗有效率分别为57.1%、41.7%和75%.结论移植肾穿刺活检为临床治疗提供了可靠的依据.急性排斥仍然是影响移植肾功能的重要因素,并且不同时间段发生的急性排斥治疗效果存在差异.提高对临界性病变的认识并早期治疗可以达到很好的效果.
목적 총결본중심이식신활검적병이학류형、특점화치료효과.방법 회고성분석본원2004년2월～2007년11월공117 례이식신천자활검적병이학자료.근거Banff97 이식신활검병이학진단여분류방안,결합환자적병사화림상표현제정상응적치료책략,병대치료효과진행수방연구.결과 117례이식신천자활검표본적병리류형위:급성배척반응공68 례,점58.1%;만성이식물신병20 례(17.1%);림계성병변11례(9.4%);CNI약물중독4례(3.4%);급성신소관배사3례(2.6%);기타포괄정상화무법학 진공11례(9.4%).경치료후,급성신소관배사화약물중독적환자전부호전.11 례림계성병변적환자,치료유효솔위81.8%.만성이식물신병적20 례환자,치료후15 리례(75%)호전.삼개시간단급성배척(O～3 개월、3～12 개월화대우12 개월)적치료유효솔분별위57.1%、41.7%화75%.결론 이식신천자활검위림상치료제공료가고적의거.급성배척잉연시영향이식신공능적중요인소,병차불동시간단발생적급성배척치료효과존재차이.제고대림계성병변적인식병조기치료가이체도흔호적효과.
Objectives To investigate the pathological feature and curative effect of renal allograft biopsies in our center.Methods Our study included 117 histopathologic diagnoses of renal allograft biopsies performed in our center from February 2004 to Nvembcr 2007.According to the Banff(1997) classification, our treatment was corresponded to the history and clinical features of the patients,and we gave an integrated follow - up vist to the prognosis of all the patients.Results The analysis revealed 68 cases of acute rejection(58.1%), 20 cases of chronic allograft nephropathy(17.1%),11 cases of borderline change(9.4%),4 Cases of nephrotoxicity(3.4%), 3 biopsies of acute tubular necrosis(2.6%),normal morphology and unknown pathological classification(9.4%). The curative effect of all the cases of acute tubular necrosis and nephrotoxicity were gratified.The curative effective rate of the 11 borderline changes Was 81.8%.The curative effective rate of 20 chronic allograft nephmpathy cases was 75%,mean while,the acute rejction cases was 57.1%(0~3 months after transplantation),41.7%(3~12 months after transplantation),75%(over 12 months after transplantation).Conclusions Renal allograft biopsy reliably indicates the treatment of different pathology.Still,acute rejection is the major complication influencing the renal function after renal transplantation,while significant difference of the curative effects of acute rejection has been ob - served in different periods of time after the operation.Early diagnosis and treatment to borderline changes results in a satisfactory curative effect.