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目的探讨成人原发性肾病综合征病理特征与治疗的关系。方法应用免疫荧光染色、光镜及电镜回顾性分析了肾穿刺活检35例成人原发性肾病综合征的临床病理特点，病理诊断按1982年WHO标准确定。结果肾病理以系膜增生性最多，占28．3％，膜增生性次之，占20％；微小病变及膜性肾病分别占14．3％和11．4％。实验室检查：血IgG降低占68．5％，血a2球蛋白增高占80％。激素疗法完全或部分缓解在弥漫增生性肾炎为70％，在膜性肾病为75％，而在微小病变为100％。结论血中IgG降低及血a2球蛋白增高可作为肾病综合征的诊断参考。激素疗法以弥漫增生性最差，膜性肾病次之，微小病变型最佳。
Objective To investigate the relationship between pathological features and treatment of adult primary nephrotic syndrome. Methods The clinical and pathological features of 35 cases of primary nephrotic syndrome were retrospectively analyzed by immunofluorescence staining, light microscopy and electron microscopy. The pathological diagnosis was based on the 1982 WHO standard. Results The mesangial proliferative pathology was the most common in renal pathology, accounting for 28.3%, followed by membrane hyperplasia, accounting for 20%. Minimal and membranous nephropathy accounted for 14.3% and 11.4% respectively. Laboratory tests: blood IgG decreased 68.5%, blood a2 globulin increased 80%. Hormone therapy completely or partially relieved at 70% for diffuse proliferative glomerulonephritis, 75% for membranous nephropathy, and 100% for minimal lesions. Conclusion The decrease of IgG in blood and the increase of blood a2 globulin can be used as a reference for the diagnosis of nephrotic syndrome. Hormone therapy to diffuse proliferative worst, followed by membranous nephropathy, minimal change minimally invasive type.