儿童原发性肾病综合征临床病理及预后的关系  

Clinical pathologic significance and the appraisal of prognoses in children with primary nephrotic syndrome

作　　者：肖慧捷[1] 刘景城[1] 陈华[2] 

机构地区：[1]北京大学第一医院儿科,100034 [2]内蒙古包钢医院儿科

出　　处：《实用儿科临床杂志》2002年第1期14-15,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的　探讨儿童原发性肾病综合征 (NS)病理学改变的临床意义和对预后的影响。方法　总结1995～ 1999年我科收治的 32例肾穿儿童原发性NS的临床及病理特征。并对肾小管间质病变进行病理分级。结果　 32例NS肾穿病理类型仍以系膜增生性肾小球肾炎 (MSPGN)为主占 6 5 % (2 1/ 32 ) ,不同肾小球病理组织类型之间肾小管间质改变无特异性。肾小管间质病变加重肾小管功能损害亦加重。结论　本文NS病理类型以MSPGN为主。多数肾小管间质的改变随着病理类型的严重程度而加重 ,部分有小球 小管间质改变不平行现象。Objective To study the relationship between clinical pathologic significance and the appraisal of prognoses in school aged children suffering from primary nephrotic syndrome.Methods The clinical and pathologic data of 32 school aged cases suffering from primary nephrotic syndrome during 1995～1999 year in our hospital were retrospectively analyzed.Renal tubulointerstitial changes were divided into IV grades.Results Mesangial proliferative glomerulonephritis is the main pathologic change in all the specimen studied , accounted for 65 %(21/32). No significant difference was found in renal tubulointerstitial changes among different clinical phenotypes. It was suggested that tubulointerstitial changes varied according to the seriousness of glomerular lesions, however that cases were not always the same.Conclusions Mesangial proliferative glomerulonephritis still ranked the top in pathologic patterns of all the specimen studied. In our brief observation, tubulointerstitial changes may act as a major determinant in the progression of renal damage. β 2 microglobulin examination may be a sensitive indicator of tubulointerstitial function.

关 键 词：儿童 肾小管间质 原发性肾病综合征 临床病理 预后 

分 类 号：R726.91[医药卫生—儿科]