CAJ | 학술논문

目的：探讨过敏性紫癜肾炎(HSPN)患儿临床与病理特点。方法选择2009年4月至2013年4月HSPN患儿89例，回顾性分析其临床及病理资料。结果多数HSPN发生于紫癜病程2个月内，89例患儿的临床分型以血尿和蛋白尿型(41.6%)、肾病综合征型(27.0%)、孤立性蛋白尿型(21.3%)多见，而三者的病理分级均以Ⅲ级多见，分别占67.6%、70.8%、73.7%。不同临床分型紫癜肾患儿病理分级分布的差异有统计学意义(H=26.88，P=0.000)。21例合并消化道出血与68例无消化道出血患儿的病理分级差异有统计学意义(Z=2.00，P=0.046)，有消化道出血患儿的病理分级多为Ⅲ级和Ⅳ级，而无消化道出血患儿多为Ⅱ级和Ⅲ级。免疫复合物分型以IgA+IgM沉积最多(40.45%)，不同免疫复合物分型的病理分级分布差异无统计学意义(P>0.05)。结论 HSPN患儿临床分型与病理分级相关，病理分级以Ⅱ和Ⅲ级多见，合并消化道出血者病理分级较重。
목적：탐토과민성자전신염(HSPN)환인림상여병리특점。방법선택2009년4월지2013년4월HSPN환인89례，회고성분석기림상급병리자료。결과다수HSPN발생우자전병정2개월내，89례환인적림상분형이혈뇨화단백뇨형(41.6%)、신병종합정형(27.0%)、고립성단백뇨형(21.3%)다견，이삼자적병리분급균이Ⅲ급다견，분별점67.6%、70.8%、73.7%。불동림상분형자전신환인병리분급분포적차이유통계학의의(H=26.88，P=0.000)。21례합병소화도출혈여68례무소화도출혈환인적병리분급차이유통계학의의(Z=2.00，P=0.046)，유소화도출혈환인적병리분급다위Ⅲ급화Ⅳ급，이무소화도출혈환인다위Ⅱ급화Ⅲ급。면역복합물분형이IgA+IgM침적최다(40.45%)，불동면역복합물분형적병리분급분포차이무통계학의의(P>0.05)。결론 HSPN환인림상분형여병리분급상관，병리분급이Ⅱ화Ⅲ급다견，합병소화도출혈자병리분급교중。
Objective To analyze the relationship between clinical and pathological features in children with Henoche-Sch?nelin purpura nephritis (HSPN). Methods Clinical and pathological data of 89 children with HSPN from April 2009 to April 2013 in our hospital were retrospectively analyzed. Results A majority of patients (94.83%) suffered nephritis within two month after purpura. Clinically, hematuria and proteinuria (41.6%), nephrotic syndrome (27.0%), and isolated protein-uria (21.3%) are the most common type in children with HSPN. The majority of pathological changes of these three types HSPN are gradeⅢ, which accounts for 67.6%, 70.8%, and 73.7%, respectively. The clinical manifestations are closely associated with pathologic classiifcation (H=26.88, P=0.000). IgA plus IgM deposit was the most common type (40.45%) in histological and immunopathologic changes.There was no statistical difference between the pathologic classification and immunopathologic types. Gastrointestinal bleeding was associated with pathologic classiifcation. Conclusions The pathological changes of HPSN patients are mainly of gradesⅡandⅢ, and the clinical manifestations, gastrointestinal bleeding in particular, are closely associated with pathological classiifcation.