509例儿童肾活检病理及临床分析  

Pathological characteristics and clinical manifestations in 509 children with renal diseases from a single unit

作　　者：谢丹凤[1] 李秋[1] 

机构地区：[1]重庆医科大学附属儿童医院肾脏免疫科,重庆400014

出　　处：《第三军医大学学报》2011年第16期1736-1739,共4页Journal of Third Military Medical University

基　　金：重庆市自然科学基金重点项目(CSTC2009BA5080);重庆市卫生局重点项目(2009-1-34)~~

摘　　要：目的探讨儿童肾小球疾病病理特点及其与临床表现的关系。方法回顾性分析2007年1月至2010年5月在重庆医科大学附属儿童医院进行肾活检的509例患儿病理及临床资料,比较原发性肾小球疾病和继发性肾小球疾病的病理和临床特征。结果①509例肾活检患儿中,原发性肾小球疾病315例,继发性肾小球疾病184例,遗传性肾小球疾病和肾血管疾病分别为6例、2例,肾小管间质性肾炎2例。②与原发性肾小球疾病组比较,继发性肾小球疾病组平均受检年龄大于原发性肾小球疾病组[(10.54±2.72)岁vs(8.62±3.28)岁],受检时平均病程较原发性肾小球疾病组短(30.00 dvs60.00 d)。③原发性肾小球疾病组最常见的临床表现和病理类型分别为肾病综合征、系膜增生性肾小球肾炎(M sPGN),继发性肾小球疾病组中分别为过敏性紫癜性肾炎和M sPGN。④近年来本院受检儿童肾小球疾病构成比发生变化。原发性肾小球疾病仍为最常见的肾小球疾病,最常见的病理类型是M sPGN和IgA肾病。孤立性血尿及狼疮性肾炎比例增加。结论肾脏病理检查技术的开展促进了肾小球疾病诊疗水平的提高,同时该技术可能也直接影响肾小球疾病住院构成比的变化。Objective To explore the relationship between the pathological characteristics and clinical manifestations of renal glomerular diseases in children.Methods Retrospective analysis was performed using the pathological and clinical data of 509 children with renal diseases to compare primary glomerular disease and secondary glomerular disease in terms of pathological characteristics and clinical manifestations.These children received renal biopsy in the Children＇s Hospital of Chongqing Medical University from January 2007 to May 2010.Results（1） Among these patients,315（61.9%） cases of primary glomerular disease,184（36.1%） cases of secondary glomerular disease,6（1.2%） cases of hereditary glomerular disease,2（0.4%） cases of renal vascular disease,and 2（0.4%） cases of renal tubulointerstitial disease were found.（2） The mean age when the renal biopsy was performed in the group of secondary glomerular disease was greater than that in the group of primary glomerular disease [（10.54±2.72） years vs.（8.62±3.28） years].The mean course of disease from onset to renal biopsy in the group of secondary glomerular disease was shorter than that in the group of primary glomerular disease（30.00 days vs.60.00 days）.（3） The most common clinical diagnosis and pathological category in the group of primary glomerular disease were nephrotic syndrome and mesangial proliferative glomerulonephritis（MsPGN）,respectively,and those in the group of secondary glomerular disease were Henoch-Schonlein purpura nephritis and MsPGN,respectively.（4） In recent years,the spectrum of children＇s renal glomerular diseases in our center changed.Primary glomerular disease was still the most common glomerular disease,and MsPGN and IgA nephropathy were the most common pathological categories.The proportions of isolated hematuria and lupus nephritis increased.Conclusion Examination of renal tissue is necessary to document the histological type and magnitude of renal injury,which are necessary in planning mana

关 键 词：肾小球疾病 病理学 临床特征 儿童 

分 类 号：R692.6[医药卫生—泌尿科学] R446.8[医药卫生—外科学]