CAJ | 학술논문

目的：分析左肾静脉受压综合征（ LRVES）合并系膜增生性肾小球肾炎（ MsPGN）的临床特点，并探讨二者间的关系。方法：对24例LRVES 合并MsPGN 患儿（病例组））及同期28例单纯LRVES患儿（对照组）的临床资料、辅助检查、肾活检病理结果进行回顾性分析。比较两组在年龄、性别、病程、尿红细胞形态、24h尿蛋白定量、尿IgG及血IgA、IgM、IgG、C3水平、左肾静脉扩张段（ D）与在其前方狭窄段（ N）的比值（ D／N）的差异。结果：两组年龄、性别、病程、血IgA、IgM、IgG、C3水平、D／N值，无统计学差异（ P＞0．05），与对照组比较，病例组尿红细胞形态以多形性为主，24h尿蛋白定量及尿IgG明显增高，差异具有统计学意义（ P＜0．05）；病例组肾活检均为MsPGN，对照组肾活检为肾小球轻微病变。结论：LRVES患儿出现多形红细胞尿、蛋白尿尤尿蛋白含量高、且提示非选择性蛋白尿者，应考虑LRVES合并肾小球疾病特别是MsPGN可能，应及早行肾穿刺明确诊断。
목적：분석좌신정맥수압종합정（ LRVES）합병계막증생성신소구신염（ MsPGN）적림상특점，병탐토이자간적관계。방법：대24례LRVES 합병MsPGN 환인（병례조））급동기28례단순LRVES환인（대조조）적림상자료、보조검사、신활검병리결과진행회고성분석。비교량조재년령、성별、병정、뇨홍세포형태、24h뇨단백정량、뇨IgG급혈IgA、IgM、IgG、C3수평、좌신정맥확장단（ D）여재기전방협착단（ N）적비치（ D／N）적차이。결과：량조년령、성별、병정、혈IgA、IgM、IgG、C3수평、D／N치，무통계학차이（ P＞0．05），여대조조비교，병례조뇨홍세포형태이다형성위주，24h뇨단백정량급뇨IgG명현증고，차이구유통계학의의（ P＜0．05）；병례조신활검균위MsPGN，대조조신활검위신소구경미병변。결론：LRVES환인출현다형홍세포뇨、단백뇨우뇨단백함량고、차제시비선택성단백뇨자，응고필LRVES합병신소구질병특별시MsPGN가능，응급조행신천자명학진단。
Objective: To analyze the clinical characteristics of left renal vein entrapment syndrome (LRVES) complicated with mesangial proliferative glomerulonephritis (MsPGN) in children, and discusse the relationship between them.Method:The clinical data, auxiliary examination, renal biopsy pathology re-sults of 24 LRVES complicated with MsPGN (Case group)) and 28 children with simple LRVES (control group) were retrospectively analyze.Compared the differences between the two groups in age, gender, course of disease, urinary red blood cell morphology, 24 hours urine protein quantitative, urine and blood IgG, IgA, IgM, IgG, C3 levels, and the ratio of the diameter ( D/N) of the left renal vein expansion section ( D) and the narrow section in the front of it( N) .Result:The age, gender, course of disease, blood IgA, IgM and IgG, C3 levels,and the D/N value of two groups has no statistical difference (P >0.05).Compared with control group, the form of most urinary red blood cells in case group was polymorphism, and 24 hours u-rine protein quantitative and urine IgG rise significantly, the difference has statistical significance ( P <0. 05);Case group's renal biopsy were MsPGN and in control group renal biopsy were glomerular minor lesion. Conclusion:When polymorphic red urine,proteinuri appearing in LRVES children especially urine protein content is high, and with non-selective proteinuria, should considering LRVES combine with glomerular, es-pecially MsPGN, and adopt renal biopsy early for diagnosis.