| BackgroundPodocyte namely glomerular overlying epithelial cells, the coating in glomerular basement membrane (glomerulor basement membrane, these GBM) outside, and these GBM endothelial cells and capillaries was composed of glomerular filtration membrane. Podocyte proteins is to avoid the loss of body the last primary barriers, podocyte damage or loss can lead to substantial glomerular sclerosis and proteinuria. Recently, research has found that podocyte structure or function abnormality in part of nephrotic syndrome, plays a key role in 2002, this kind of Barisoni for the first time, such as by foot cell structure and function abnormality of nephrotic syndrome caused called podocyte disease. Idiopathic podocyte disease mainly includes tiny lesions (MCD), the membranous nephropathy (MN), focal phased glomerular sclerosis (FSGS). At present domestic use more combining traditional Chinese and western medicine treatment of disease, therefore, the understanding of the disease development trend, clinical manifestation and pathologic types with distribution and the correlation of syndromes, can provide for TCM syndrome differentiation in modern pathology and improve the objective index of clinical medicine treatment level.ObjectivesThe issue of August 2002 through in March-2011 Department of Nephrology, Guangdong Provincial Hospital of Chinese medicine of kidney biopsy pathology report meets the 178 Podocyt disease patients with pathological data and clinical data summary, understanding the pathogenesis of Podocyte disease trends and clinical manifestations and pathology of Podocyte disease classification and distribution of syndrome links for TCM to provide objective indicators of modern pathology, thus improve the clinical treatment of Chinese and western standards.MethodsA retrospective study, to collect the Guangdong Provincial Hospital of Chinese medicine of Nephrology Dept., August 2002-2011 in March due to kidney disease, percutaneous kidney biopsy in patients with general information, refer to WHO glomerular disease, tubulointerstitial disease, renal vascular disease histological amendments, combined with clinical data, laboratory tests, pathology and ultrastructure features of the immune pathology consistent with the 178 Podocyt disease patients. Further reference to the Chinese Medical Association 1977 nephritis in Beidaihe, seminars and in 1986 the Second National Conference on Chinese renal dialectical revised classification scheme for the various cases of TCM syndrome. According to the results of the statistics of frequency of renal biopsy in our hospital prompted Podocyte Disease clinical data, pathological data and the distribution of syndromes, the application of statistical methods related to analysis of minimal change disease (MCD) respectively, membranous nephropathy (MN), focal segmental glomerulonephritis (FSGS) in patients with syndromes, clinical characteristics and associated clinical data, correlation analysis, analysis of the specific, the relevance of the internal links.Results1. The group of 178 patients in the MCD 68 cases, accounting for 38.2%, MN 67 cases, accounting for 37.6%, FSGS 43 cases, accounting for 24.2%. kidney biopsy of the average age of (36.32±16.69) years, range (13-72) years of age, high age of 20-29 years old, male 92 cases (51.7%), female 86 cases (48.3%).2.68 cases of MCD patients,38 males, accounting for 55.9%, female 30 cases,accounting for 44.1%, average age (30.90±14.539) years of age, high age of 20-29 years.67 cases of MN patients,26 males, accounting for 38.8%, female 41 cases, accounting for 61.2%, average age (45.93±16.30) years of age, high age of 50-59 years old.43 cases of FSGS patients,28 males, accounting for 65.1%, female 15 cases, accounting for 34.9%, average age (29.93 ±13.50) years of age, high age of 13-19 years.3.178 cases of patients with clinical manifestations of western medicine, the overall nephrotic syndrome (NS) the most common,143 cases (80.3%), others 35 cases (19.7%) Chinese medicine clinical manifestations, the most common overall in edema,147 patients (82.6%), urine turbid in 29 cases (16.3%), hematuria in 2 cases (1.2%). This set of data in the MCD, MN, FSGS are the main clinical manifestations of NS (respectively 92.6%,77.6%,65.1%).4. Our hospital MCD, MN, FSGS TCM syndromes are the virtual standard evidence-based, accounting for 86.8%,98.5% and 100%. The deficiency of spleen qi deficiency are more common, standard evidence to damp more common (respectively 69.1%,77.6%,67.4%), respectively,52.9%,50.7%,53.5%.75.8% of patients with blood stasis and folders. Among different pathological types of syndromes was no significant difference (P> 0.05).5. In this group 85.5% of the electron microscopy has played a determining role in the diagnosis of light microscopy, part of the pathological diagnosis, such as minimal change disease, membranous nephropathy and other early because the results of electron microscopy has been diagnosed and fixed.ConclusionPodocyte Disease is a type of Podocyte structure or function is impaired due to pathological changes, to a large number of proteinuria as the main performance, of the renal biopsy in our hospital pathology consistent with the 178 Podocyte disease patients with clinical data, found that the Class of clinical manifestations in patients with nephrotic syndrome-based, performance-based TCM syndromes virtual real, the virtual to the main spleen qi deficiency, blood stasis standards-based implementation in order to humid, suggesting that our treatment of such diseases is to benefit qi for the treatment of blood, to receive good clinical efficacy. |
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