中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2014年
7期
412-414
,共3页
罗苇%冯仕品%王莉%谢敏%刘君
囉葦%馮仕品%王莉%謝敏%劉君
라위%풍사품%왕리%사민%류군
紫癜性肾炎%儿童%临床%病理
紫癜性腎炎%兒童%臨床%病理
자전성신염%인동%림상%병리
Henoch-Sch(o)nlein purpura nephritis%Children%Clinic%Pathology
目的 了解儿童紫癜性肾炎的临床和病理特点.方法 回顾性分析279例儿童紫癜性肾炎患儿的临床和病理资料.结果 279例儿童紫癜性肾炎的临床分型以血尿和蛋白尿型最多(t07例,38.4％),其次是肾病综合征型(69例,24.7％),孤立性蛋白尿型(40例,14.3％),孤立性血尿型(29例,10.4％),急性肾炎型(21例,9.3％),急进性肾炎型(8例,2.9％),慢性肾炎型(5例,1.8％).根据国际儿童肾脏病研究中心标准,279例儿童紫癜性肾炎的病理分级以Ⅱ级和Ⅲ级最多,分别为133例(47.7％)和109例(39.1％),血尿和蛋白尿型的病理分级以Ⅱ级(61例,57.0％)和Ⅲ级(35例,32.7％)多见,肾病综合征型的病理分级以Ⅲ级多见(41例,59.4％).免疫病理分型以IgA+ IgM沉积型多见(108例,38.7％),IgA+ IgM+ IgG沉积型次之(86例,30.8％).肾病综合征型的病理改变相对较重(x2=35.989,P＜0.05),免疫病理分型与病理分级无相关性(P＞0.05).结论 儿童紫癜性肾炎临床以血尿和蛋白尿型及肾病综合征型为主,病理分级以Ⅱ级和Ⅲ级常见,但临床症状与病理损伤的程度不完全一致,肾病综合征型的病理改变相对较重.应根据临床类型和病理分级制定治疗计划,改善预后.
目的 瞭解兒童紫癜性腎炎的臨床和病理特點.方法 迴顧性分析279例兒童紫癜性腎炎患兒的臨床和病理資料.結果 279例兒童紫癜性腎炎的臨床分型以血尿和蛋白尿型最多(t07例,38.4％),其次是腎病綜閤徵型(69例,24.7％),孤立性蛋白尿型(40例,14.3％),孤立性血尿型(29例,10.4％),急性腎炎型(21例,9.3％),急進性腎炎型(8例,2.9％),慢性腎炎型(5例,1.8％).根據國際兒童腎髒病研究中心標準,279例兒童紫癜性腎炎的病理分級以Ⅱ級和Ⅲ級最多,分彆為133例(47.7％)和109例(39.1％),血尿和蛋白尿型的病理分級以Ⅱ級(61例,57.0％)和Ⅲ級(35例,32.7％)多見,腎病綜閤徵型的病理分級以Ⅲ級多見(41例,59.4％).免疫病理分型以IgA+ IgM沉積型多見(108例,38.7％),IgA+ IgM+ IgG沉積型次之(86例,30.8％).腎病綜閤徵型的病理改變相對較重(x2=35.989,P＜0.05),免疫病理分型與病理分級無相關性(P＞0.05).結論 兒童紫癜性腎炎臨床以血尿和蛋白尿型及腎病綜閤徵型為主,病理分級以Ⅱ級和Ⅲ級常見,但臨床癥狀與病理損傷的程度不完全一緻,腎病綜閤徵型的病理改變相對較重.應根據臨床類型和病理分級製定治療計劃,改善預後.
목적 료해인동자전성신염적림상화병리특점.방법 회고성분석279례인동자전성신염환인적림상화병리자료.결과 279례인동자전성신염적림상분형이혈뇨화단백뇨형최다(t07례,38.4％),기차시신병종합정형(69례,24.7％),고립성단백뇨형(40례,14.3％),고립성혈뇨형(29례,10.4％),급성신염형(21례,9.3％),급진성신염형(8례,2.9％),만성신염형(5례,1.8％).근거국제인동신장병연구중심표준,279례인동자전성신염적병리분급이Ⅱ급화Ⅲ급최다,분별위133례(47.7％)화109례(39.1％),혈뇨화단백뇨형적병리분급이Ⅱ급(61례,57.0％)화Ⅲ급(35례,32.7％)다견,신병종합정형적병리분급이Ⅲ급다견(41례,59.4％).면역병리분형이IgA+ IgM침적형다견(108례,38.7％),IgA+ IgM+ IgG침적형차지(86례,30.8％).신병종합정형적병리개변상대교중(x2=35.989,P＜0.05),면역병리분형여병리분급무상관성(P＞0.05).결론 인동자전성신염림상이혈뇨화단백뇨형급신병종합정형위주,병리분급이Ⅱ급화Ⅲ급상견,단림상증상여병리손상적정도불완전일치,신병종합정형적병리개변상대교중.응근거림상류형화병리분급제정치료계화,개선예후.
Objective To study the feature of clinical and pathological type of Henoch-Sch(o)nlein purpura nephritis (HSPN) in children.Methods Clinical and pathological data of HSPN in 279 children were collected and retrospectively analyzed.Results Clinical manifestation of HSPN in 279 children with haematuria and proteinuria (107 cases,38.4％) was the most common type,followed by nephritic syndrome type (69 cases,24.7％),isolated proteinuria type (40 cases,14.3％),isolated hematuria type (29 cases,10.4 ％),acute glomerulonephritis type (21 cases,9.3 ％),rapidly progressive glomerulonephritis type (8 cases,2.9％),chronic glomerulonephritis type (5 cases,1.8％).According to the International Study of Kidney Disease in Children,the majority renal pathological type of HSPN were grade Ⅱ (133 cases,47.7％)and grade Ⅲ (109 cases,39.1％).The pathological changes of hematuria and proteinuria type were mainly grade Ⅱ (61 cases,57.0％) and grade Ⅲ (35 cases,32.7％),and the pathological change of nephritic syndrome type was grade Ⅲ (41 cases,59.4％).All of renal pathological changes,38.7％ (108/279) had codeposition of immunoglobulins A and M,30.8％ (86/279) had co-deposition of immunoglobulins A,G and M.The pathological change of nephritic syndrome type was more serious (x2 =35.989,P ＜ 0.05).Immune complex deposition was not correlated with renal pathologic classification (P ＞ 0.05).Conclusion The HSPN patients mainly show the type of hematuria and proteinuria and the type of nephritic syndrome.The majority renal pathological type of HSPN are grade Ⅱ and grade Ⅲ.In children with HSPN,the severity of the clinic symptoms is not completely consistent with the pathological changes.The pathological changes of nephritic syndrome type are more serious.To improve theprognosis of HSPN,we should make the treatment planning according to the clinical types and pathologic classification.
