紫癜性肾炎的临床病理研究及青少年和成人的比较  

Clinicopathological features of Henoch-Schnlein nephritis and the difference between adolescent and adult patients

作　　者：严玉澄[1] 张敏芳[1] 姚莒华[1] 钱家麒[1] 

机构地区：[1]上海第二医科大学附属仁济医院肾脏科,200001

出　　处：《中华肾脏病杂志》2001年第4期222-225,共4页Chinese Journal of Nephrology

摘　　要：目的 研究紫癜性肾炎的临床病理表现及青少年和成人紫癜性肾炎的不同特点。方法 对３１例紫癜性肾炎患者的临床表现、实验室及组织学检查进行分级或定量分析，并分别比较青少年组和成人组的情况。结果 首次皮肤紫癜后１月内出现尿液异常的患者青少年多于成人（分别为9２．９％和４７．１％）。临床表现以中等量蛋白尿最多（４８．４％），肾病范围的蛋白尿青少年略多于成人。高血压发生率、肾小球周围炎症、间质细胞浸润及小血管病变成人多于青少年。新月体在紫癜性肾炎中较常见（６４．５％）。蛋白尿与组织学表现之间存在相关性。血ＩｇＡ水平成人高于青少年[（２．８１±1．３５）ｇ／Ｌ，（１．８９±０．７１）ｇ／Ｌ，Ｐ＜０．０５］。结论 紫癜性肾炎在青少年和成人之间存在一些不同的临床和组织学特点，病理和临床有一定的联系，血 ＩｇＡ水平并不反应疾病的活动性。Objective To evaluate the difference of clinicopathological features between adolescent and adult patients in Henoch-Schonlein nephritis. Methods Clinical presentations and pathological features were investigated in 31 patients with Henoch-Schonlein nephritis. Results Abnormal urinalysis after the purpura rush was earlier in the adolescent as compared with the adult. Moderate proteinuria was the most common clinical feature(48. 4%) and nephrotic proteinuria was more usual in the adolescent than in the adult. But the hypertension, periglomerular inflammation, interstitial infiltration and the vascular lesion occurred more frequently in the adult. Crescents formation was found commonly(64. 5%) . There was a correlation between proteinuria and histological change& The serum level of IgA in the adult was higher than that in the adolescent [(2.81+1.35) g/L vs(1.89+0.71) g/L, P <.05]. Conclusions There are some differences of clinicopathology between the adolescent and the adult cases with Henoch-Schonein nephritis. Pathology is correlated with the clinical presentations and the serum level of IgA does not reflect the activity of the disease.

关 键 词：临床 病理 紫癜性肾炎 青少年 成人 

分 类 号：R692.3[医药卫生—泌尿科学]