小儿肾活检246例病理结果分析  

Pathologic Analysis of 246 Cases with Renal Biopsy in Children

作　　者：丁樱[1] 杨晓青[1] 

机构地区：[1]河南中医学院第一附属医院儿科,郑州450000

出　　处：《实用儿科临床杂志》2009年第17期1322-1324,共3页Journal of Applied Clinical Pediatrics

基　　金："十一.五"国家科技支撑计划项目资助(2006BAI04A16)

摘　　要：目的探讨小儿肾脏疾病的病理分布特点。方法回顾性分析246例小儿肾活检资料,参照WHO 1995年改良肾小球疾病组织学分型修订方案进行病理分型。结合临床资料、实验室检查、免疫病理及超微结构改变特点作出诊断。结果246例患儿中原发性肾小球肾炎104例(42.28%),继发性肾小球肾炎136例(55.28%),遗传性肾病3例(1.22%),不能分类3例(1.22%)。原发性肾小球肾炎中临床表现为肾病综合征66例,迁延性肾炎23例,急性肾炎8例,慢性肾炎3例,孤立性蛋白尿2例,孤立性血尿、急进性肾炎各1例。病理表现以IgA肾病(39例,15.85%)为主,其次为系膜增生性肾炎和微小病变型肾病,再次为IgM肾病、毛细血管内增生性肾炎、局灶性节段性肾小球硬化、膜性肾病、轻微病变肾病。继发性肾小球肾炎以紫癜性肾炎(119例,48.37%)为主,其次为乙型肝炎相关性肾炎(11例)和狼疮性肾炎(6例)。遗传性肾病中临床表现为孤立性血尿2例,迁延性肾炎1例,病理表现为薄基膜肾病2例,A lport综合征1例。结论246例肾活检病例中以继发性肾小球肾炎为主,紫癜性肾炎是最常见的继发性肾小球肾炎;IgA肾病是原发性小球肾炎中最常见的病理类型。Objective To explore the pathologic feature of children with kidney disease. Methods A retrospective analysis on renal bio-psy findings in 246 cases of children patients. Pathological classification was made according to the modified WHO criteria of 1995 for renal pathology. Results Of the 246 children, 104 cases were diagnosed as primary glomerulonephritis, accounting for 42.28% of the total cases, 136 cases as secondary glomerulonephritis, accounting for 42.28% ,3 cases as hereditary nephritis, accounting for 1.22%, and 3 cases as unclassified renal disease,accounting for 1.22%. In primary glomerulonephritis,66 cases were diagnosed as nephrotie syndrome,23 cases as persistent glomeruloneplritis, 8 cases as acute nephritis syndrome ,3 cases as chronic nephritis syndrome ,2 cases as isolated proteinuria, 1 case as rapidly progressive glomerulonephritis, 1 case as isolated hematuria. IgA nephropathy was the most frequent pathological type, accounting for 15.85% （39 cases）, followed by mesangial proliferative glomerulonephritis, minimal change disease, endocapillary proliferative glomerulinephritis, lgM nephropathy, membranous nephropathy, focal segmental glomerulosclerosis, and minor lesion nephropathy. In secondary glomerulonephritis, Henoch -Sehonlein purpura nephritis accounting for 48.37% （119 cases） ,followed by hepatitis B virus associated nephritis（ 11 cases） and lupus nephritis（6 cases）. In hereditary nephritis,there were 2 cases with thin glomerular basement disease and 1 case with Alport syndrome. Conclusions Among the 246 cases of renal biopsy data, the secondary glomerulonephritis,especially Henoch - Schonlein purpura nephritis,is more common than primary glomerulonephritis. In primary glomerular diseases, IgA nephropathy is the most frequent pathological type.

关 键 词：回顾性分析 肾活检 病理分型 儿童 

分 类 号：R726.9[医药卫生—儿科]