中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (31): 5737-5741.doi: 10.3969/j.issn.2095-4344.2012.31.009

• 肾移植 • 上一篇    下一篇

移植肾穿刺20例活组织病理检查的临床价值

裴向克1, 2，韩 永2，王 强3，许 亮2，郭 晖3，石炳毅2，蔡 明2   

  1. 1解放军第281医院泌尿外科，河北省秦皇岛市 066100；
    2解放军第309医院全军器官移植中心，北京市 100091；
    3华中科技大学同济医学院附属同济医院器官移植研究所，湖北省武汉市 430030  
  • 收稿日期:2011-12-15 修回日期:2011-12-15 出版日期:2012-07-29 发布日期:2012-07-29
  • 通讯作者: 蔡明，主任医师，硕士生导师，教授，解放军第309医院全军器官移植中心，北京市 100091 caiming@ medmail.com
  • 作者简介:裴向克☆，男，1975年生，天津市人，2008年解放军军医进修学院(解放军总医院)毕业，博士，主治医师，主要从事器官移植及泌尿外科研究工作。 pxkmail@126. com

Percutaneous biopsy of renal allograft: Analysis of pathological and clinical value in 20 cases

Pei Xiang-ke1, 2, Han Yong2, Wang Qiang2, Xu Liang2, Guo Hui3, Shi Bing-yi2, Cai Ming2   

  1. 1Department of Urology, the 281 Hospital of Chinese PLA, Qinhuangdao 066100, Hebei Province, China;
    2Chinese PLA Organ Transplantation Center, the 309 Hospital of Chinese PLA, Beijing 100091, China;
    3Institute of Organ Transplantation, Affiliated Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
  • Received:2011-12-15 Revised:2011-12-15 Online:2012-07-29 Published:2012-07-29
  • Contact: Cai Ming, Chief physician, Master’s supervisor, Professor, Chinese PLA Organ Transplantation Center, the 309 Hospital of Chinese PLA, Beijing 100091, China caiming@medmail. com
  • About author:Pei Xiang-ke☆, Doctor, Attending physician, Department of Urology, the 281 Hospital of Chinese PLA, Qinhuangdao 066100, Hebei Province, China; Chinese PLA Organ Transplantation Center, the 309 Hospital of Chinese PLA, Beijing 100091, China pxkmail@126.com

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被引次数

1

摘要：

背景：根据临床表现、无创性辅助检查及临床经验来判断肾移植后移植肾功能异常的原因常常会陷入困境，经皮肾穿刺活组织检查则可提供重要的循证学依据。
目的：探讨移植肾穿刺活组织检查的临床意义。
方法：回顾性分析20例移植肾穿刺活检病理资料及相应调整治疗后的临床结果资料。
结果与结论：20例患者病理诊断为急性排斥反应7例(35%)，可疑性急性排斥反应2例(10%)，可疑性急性排斥反应加免疫抑制剂中毒1例(5%)，免疫抑制剂中毒3例(15%)，慢性移植肾肾病3例(15%)，未见明确异常3例(15%)，肾小管坏死1例(5%)。相应调整治疗方案后，移植肾功能恢复正常9例(45%)，移植肾功能好转7例(35%)，肾功能无明显变化3例(15%)，肾功能轻度恶化1例(5%)。结果可见肾穿刺活组织检查对肾移植后肾功能异常的病因诊断有重要的价值，有利于指导治疗方案的调整。

关键词: 肾移植, 肾穿刺, 病理诊断, 肾功能异常, 急性排斥反应

Abstract:

BACKGROUND: To determine the cause of graft renal dysfunction after renal transplantation based on the clinical manifestations, non-invasive examinations and clinical experience is often in trouble, percutaneous renal biopsy can provide important evidence-based theory.
OBJECTIVE: To investigate the clinical significance of renal allograft biopsy.
METHODS: Pathological data of 20 patients with renal allograft biopsy and the clinical outcome of accordingly adjusted treatment were retrospectively analyzed.
RESULTS AND CONCLUSION: Acute rejection occurred in seven cases (35.0%), doubtful acute rejection occurred in two cases (10.0%), doubtful acute rejection combined drug poisoning occurred in one cases (5.0%), drug poisoning occurred in three cases (15.0%), chronic allograft nephropathy occurred in three cases (15.0 %), no obvious abnormality occurred in three cases (15.0%), acute renal tubular necrosis occurred in one case (5.0%). After therapeutic regimen was adjusted, graft function of nine cases (45%) returned to normal, seven cases (35%) improved, three cases (15%) did not change markedly and one case (5%) deteriorated slightly. Renal graft biopsy is important for the etiological diagnosis of the graft function deterioration after kidney transplantation and is in favor of the adjustment of the therapeutic regimen.

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