儿童紫癜性肾炎足突融合与肾脏病理分级相关性研究  

Discussion of relationship between renal pathology and glomerular podocyte injury in childhood Henoch-Schnlein purpura nephritis

作　　者：任献国[1] 张沛[1] 杜丽芳[2] 高远赋[1] 樊忠民[1] 高春林[1] 茅松[1] 何旭[1] 夏正坤[1] 任献青[3] 刘光陵[4] 

机构地区：[1]南京军区南京总医院儿科,江苏南京210003 [2]南京中医药大学,江苏南京210009 [3]河南中医学院第一附属医院,河南郑州450000 [4]解放军第309医院,北京100091

出　　处：《中国实用儿科杂志》2013年第7期512-515,共4页Chinese Journal of Practical Pediatrics

基　　金："十一五"国家科技支撑计划(2006BAI04A16)

摘　　要：目的探讨儿童紫癜性肾炎(Henoch-Schnlein purpura nephritis,HSPN)足突融合与肾脏病理分级的相关性。方法回顾性分析2008年1月1日至2011年1月1日南京军区南京总医院儿科肾活检病理检查诊断为过敏性紫癜性肾炎的住院病例72例,对其进行病理分级和免疫荧光分型,并在电镜下观察足细胞足突融合情况。结果病理分级按照国际儿童肾脏病学会(ISKDC)分类集中在Ⅱ级和Ⅲ级,其中病理分级为Ⅱ级的患儿34例(47.2%),病理分级为Ⅲ级38例(52.8%)。电镜下观察肾小球足细胞损伤情况:足突广泛融合21例,足突节段融合35例和无足突融合11例;5例电镜下未见肾小球。足突广泛融合患儿病理分级为Ⅲ级者较足突节段融合、无足突融合者多。足突广泛融合患儿中免疫荧光分型以IgA+IgM+IgG型最多;足突节段融合患儿中免疫荧光分型以IgA+IgG型较多,无足突融合患儿中免疫荧光分型以单纯IgA型最多。结论儿童HSPN的肾小球病理改变除了系膜细胞的增生外,还存在足细胞损伤的情况,足细胞损伤情况越重病理改变越明显。Objective To analyze relationship between renal pathology and glomerular podocyte food processes fused in childhood Henoch-Schtinlein purpura nephritis. Methods Renal pathological types of 72 children suffering from HSPN were reviewed during the period from January 1st 2008 to January 1st 2011 from Nanjing Command of Jingling Hospital. Pathological grading and immunofluorescenee typing were analyzed. The information of podocyte food process- es fused was showed by electron microscopy. Results Pathological findings were classified as ISKDC （the International Society of Kidney Disease in Children） grade II in 34 （47.2%） and grade VI in 38 （52.8%）. Glomerular podoeyte injury was classified by electron microscope as food processes of podocyte fused extensively in 21 cases, food processes of podo- eyte fused segmentally in 35 cases, food processes of podocyte without fusion in 1 lcases.There was no renal glamorous in nephridial tissue by electron microscope in five cases. Conclusion The childhood HSPN is expressed with foot pro- cess of podocytes fused more extensively on electron microscope besides glomerular pathologic change. The more serious the degree of podocyte injury is, the more obvious the pathologic changeis.

关 键 词：紫癜性肾炎 病理分级 足细胞损伤 儿童 

分 类 号：R72[医药卫生—儿科]