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目的了解近年60岁以上肾病综合征患者临床表现和病理类型特点。方法收集我院2004年1月～2009年2月肾病综合征患者67例,年龄≥60岁,对其临床表现及肾活检病理进行分析。结果肾病综合征患者67例,原发性肾小球疾病者56例(83.58%),病理类型以局灶性节段性肾小球硬化最常见,其次为膜性肾病、局灶增生性肾小球肾炎、IgA肾病;继发性肾病综合征11例(16.42%)。除肾病综合征表现外,伴血尿50例(74.63%),伴高血压者36例(53.73%),伴慢性肾衰竭者33例(49.25%)。病程中出现感染者14例(20.90%)。肾活检后无严重合并症。结论 60岁以上肾病综合征患者最常见的病因为原发性肾小球疾病,病理类型以局灶性节段性肾小球硬化最常见;主要临床表现为浮肿、蛋白尿,血尿、高血压、肾功能减退发生率高;患者行肾活检是安全的。
Objective To understand the clinical manifestations and pathological features of patients with nephrotic syndrome over 60 years old in recent years. Methods A total of 67 patients with nephrotic syndrome were collected from January 2004 to February 2009 in our hospital. The patients were ≥60 years old. Their clinical manifestations and renal biopsy were analyzed. Results 67 cases of nephrotic syndrome, 56 cases of primary glomerular disease (83.58%), the most common pathological type of focal segmental glomerulosclerosis, followed by membranous nephropathy, focal proliferative kidney Glomerular nephritis, IgA nephropathy; secondary nephrotic syndrome in 11 cases (16.42%). In addition to nephrotic syndrome, 50 cases (74.63%) with hematuria, 36 cases (53.73%) with hypertension, and 33 cases (49.25%) with chronic renal failure. During the course of the disease, 14 cases (20.90%) were infected. No serious complications after renal biopsy. Conclusions The most common cause of nephrotic syndrome in patients over 60 years old is primary glomerular disease. The most common pathological type is focal segmental glomerulosclerosis. The main clinical manifestations include edema, proteinuria, hematuria, hypertension , The incidence of renal dysfunction is high; patients with renal biopsy is safe.