[摘要] 目的 了解炎症性肠病肾脏损害的临床及病理特点。 方法 对2010年5月～2018年12月在我院诊断为炎症性肠病肾损害的21例患者的临床资料进行分析、总结，对其中行肾穿刺活检的13例患者的活检病理特点进行描述。 结果 21例炎症性肠病肾损害患者中，男7例，女14例，溃疡性结肠炎患者16例，克罗恩病患者5例。其中13例患者行肾穿刺活检，病理类型包括IgA肾病6例，膜性肾病3例，间质性肾炎3例，新月体肾炎1例。 结论 IBD患者可以出现不同类型的病理损害，其中以IgA肾病、间质性肾炎以及膜性肾病最为常见。
[关键词] 炎症性肠病;溃疡性结肠炎;克罗恩病;肠外表现;肾脏受累
[中图分类号] R574 [文献标识码] B [文章编号] 1673-9701（2019）34-0132-04
Clinicopathological analysis of renal damage in inflammatory bowel disease
ZHONG Yongzhong YIN Jiazhen TANG Xuanli LI Xianfa CHEN Hongyu ZHU Bin
Department of Nephropathy， Hangzhou Hospital of Traditional Chinese Medicine， Hangzhou 310007， China
[Abstract] Objective To investigate the clinical and pathological features of renal damage in inflammatory bowel disease. Methods The clinical data of 21 patients who were diagnosed with renal damage in inflammatory bowel disease in our hospital from May 2010 to December 2018 were analyzed and summarized， and the biopsy pathological characteristics of 13 of them who received needling biopsy of kidney were described. Results Among the 21 patients with renal damage in inflammatory bowel disease， 7 were male， 14 were female， 16 were with ulcerative colitis and 5 were with Crohn’s disease. Thirteen patients were given needling biopsy of kidney， and IgA nephropathy（6 cases）， membranous nephropathy（3 cases）， interstitial nephritis （3 cases）， and crescent nephritis（1 case） were included in the pathological types. Conclusion IBD patients can have different types of pathological damage， of which IgA nephropathy， interstitial nephritis and membranous nephropathy are the most common.
[Key words] Inflammatory bowel disease（IBD）; Ulcerative colitis; Crohn’s disease; Extraintestinal manifestations; Renal involved
炎癥性肠病（Inflammatory bowel disease，IBD）是一组病因未明的慢性非特异性肠道炎症性疾病，包括克罗恩病（Crohn"s disease，CD）和溃疡性结肠炎（ulcerative colitis，UC），其具体病因及发病机制目前尚未完全阐明，可能与肠道黏膜系统异常的免疫反应有关，临床表现为腹痛、腹泻、黏液性脓血便等症状。除累及消化系统外，由IBD引起的其他系统病变称之为炎症性肠病肠外表现（extraintestinal manifestations，EIMs）。EIMs发生率约为6%～47%[1-4]，受累组织器官包括皮肤、骨骼、肌肉、关节及眼睛等[5]。肾脏作为炎症性肠病的肠外累及器官之一，临床表现包括尿路结石、蛋白尿、血尿以及肾功能异常等[6]。由于炎症性肠病肾损害的临床表现较为隐匿，易被忽视。因此，本研究旨在观察炎症性肠病肾损害的临床及病理特点，以提高炎症性肠病肾受累的认识。
1 资料与方法
1.1一般资料
选取2010年5月～2018年12月因肾脏疾病在我科住院患者，住院前或住院期间确诊为IBD，IBD的诊断符合IBD国际诊断标准[7，8]。除外其他继发性肾病，如狼疮性肾炎、高血压肾损害、慢性乙型病毒性肝炎相关性肾炎、过敏性紫癜性肾炎等，最终诊断为炎症性肠病肾损害21例。
