CAJ | 학술논문

目的：对比研究临床大量蛋白尿表现的 IgA 肾病( IgA nephropathy,IgAN)和儿童紫癜性肾炎( Henoch-Sch?nlein purpura nephritis,HSPN)的临床和肾脏病理改变的异同。方法收集大量蛋白尿表现的26例 IgAN和41例HSPN患儿的临床资料和病理资料并进行回顾性分析。结果大量蛋白尿表现的IgAN患儿和HSPN患儿在年龄、性别方面比较差异无统计学意义( P >0．05)。与大量蛋白尿的 HSPN 患儿相比较,大量蛋白尿的 IgAN 更易出现血尿( P <0．05),24h尿蛋白、血胆固醇水平更高,血白蛋白更低(P<0．05),临床表现更重。有大量蛋白尿的IgAN患儿和HSPN患儿肾脏免疫复合物沉积比较差异无统计学意义(P>0．05),但IgAN患儿较HSPN患儿在肾小球硬化、肾小管炎症细胞浸润、肾小管萎缩和间质纤维化方面更常见(P<0．05)。结论大量蛋白尿表现的的IgAN比HSPN患儿临床表现重,病理改变更趋慢性化。
목적：대비연구림상대량단백뇨표현적 IgA 신병( IgA nephropathy,IgAN)화인동자전성신염( Henoch-Sch?nlein purpura nephritis,HSPN)적림상화신장병리개변적이동。방법수집대량단백뇨표현적26례 IgAN화41례HSPN환인적림상자료화병리자료병진행회고성분석。결과대량단백뇨표현적IgAN환인화HSPN환인재년령、성별방면비교차이무통계학의의( P >0．05)。여대량단백뇨적 HSPN 환인상비교,대량단백뇨적 IgAN 경역출현혈뇨( P <0．05),24h뇨단백、혈담고순수평경고,혈백단백경저(P<0．05),림상표현경중。유대량단백뇨적IgAN환인화HSPN환인신장면역복합물침적비교차이무통계학의의(P>0．05),단IgAN환인교HSPN환인재신소구경화、신소관염증세포침윤、신소관위축화간질섬유화방면경상견(P<0．05)。결론대량단백뇨표현적적IgAN비HSPN환인림상표현중,병리개변경추만성화。
Objective To compare the clinical and pathological charactersistics with IgA nephropathy(IgAN)and He-noch-Sch?nlein purpura nephritis( HSPN) with proteinuria in children. Methods 26 cases of IgAN and 41 cases of HSPN with high-grade proteinuria in children were retrospectively collected and analyzed. Results There were no significant differences in age and sex between the IgAN and HSPN with high-grade proteinuria groups(P>0. 05). Hematuria was more common in the IgAN group than in the HSPN group(P<0. 05). In IgAN group,24-hour urine protein and serum cholesterol levels were higher than that in HSPN group(P<0. 05), and serum albumin level was lower than that in HSPN group(P<0. 05). There was no statistical sig-nificance in IgAN group and HSPN group with renal immune complex deposition difference(P>0. 05). But in IgAN group, glo-merular sclerosis,renal inflammatory cell infiltration,tubular atrophy and interstitial fibrosis were more common than that in HSPN group( P <0. 05 ) . Conclusion The clinical manifestation of IgAN with high-grade proteinuria were heavier than HSPN with high-grade proteinuria in children, and more chronic pathological in children with IgAN with high-grade proteinuria.