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目的探讨不同的组织器官活检诊断系统性淀粉样变的阳性率。方法回顾性分析2009年1月至2015年6月北京协和医院确诊的194例系统性淀粉样变患者的临床资料和活检结果。结果受累器官活检是阳性率最高的活检部位,其中肾脏、心脏和肝脏的阳性率分别为97.4%、95.0%和87.5%。而在微创性活检部位中,阳性率由高到低分别为舌体75%、齿龈57%、腹壁脂肪57%、直肠16%和骨髓8%。联合舌体与腹壁脂肪活检可使阳性率提高到93.1%。结论受累器官活检仍然是阳性率最高的活检方式,联合多部位的微创活检可能达到与受累器官活检相近的阳性率,且更为方便安全。
Objective To investigate the positive rate of systemic amyloidosis in different tissues and organs biopsy. Methods The clinical data and biopsy results of 194 patients with systemic amyloidosis diagnosed at Peking Union Medical College Hospital from January 2009 to June 2015 were retrospectively analyzed. Results The organ biopsy was the most positive biopsy site. The positive rates of kidney, heart and liver were 97.4%, 95.0% and 87.5% respectively. In minimally invasive biopsy sites, the positive rates from high to low were 75% of the tongue, gums 57%, 57% of abdominal fat, 16% of rectum and 8% of bone marrow. Combined tongue and abdominal fat biopsy can make the positive rate increased to 93.1%. Conclusion Invasive organ biopsy is still the biopsy method with the highest positive rate. Combined with multi-site minimally invasive biopsy may reach the positive rate close to the biopsy involved, and is more convenient and safe.