儿童左肾静脉受压综合征并发系膜增生性肾小球肾炎临床特点分析  

Clinical Characteristics of Left Renal Vein Entrapment Syndrome Complicated with Mesangial Proliferative Glomerulonephritis

作　　者：江家云 朱颖 董扬 徐达良 

机构地区：[1]安徽省儿童医院肾内科,安徽合肥230051

出　　处：《河北医学》2015年第8期1402-1405,共4页Hebei Medicine

基　　金：安徽省卫生厅研究基金项目;(编号:2010B028)

摘　　要：目的:分析左肾静脉受压综合征(LRVES)合并系膜增生性肾小球肾炎(MsPGN)的临床特点,并探讨二者间的关系。方法:对24例LRVES合并MsPGN患儿(病例组))及同期28例单纯LRVES患儿(对照组)的临床资料、辅助检查、肾活检病理结果进行回顾性分析。比较两组在年龄、性别、病程、尿红细胞形态、24h尿蛋白定量、尿IgG及血IgA、IgM、IgG、C3水平、左肾静脉扩张段(D)与在其前方狭窄段(N)的比值(D/N)的差异。结果:两组年龄、性别、病程、血IgA、IgM、IgG、C3水平、D/N值,无统计学差异(P>0.05),与对照组比较,病例组尿红细胞形态以多形性为主,24h尿蛋白定量及尿IgG明显增高,差异具有统计学意义(P<0.05);病例组肾活检均为MsPGN,对照组肾活检为肾小球轻微病变。结论:LRVES患儿出现多形红细胞尿、蛋白尿尤尿蛋白含量高、且提示非选择性蛋白尿者,应考虑LRVES合并肾小球疾病特别是MsPGN可能,应及早行肾穿刺明确诊断。Objective： To analyze the clinical characteristics of left renal vein entrapment syndrome（ LRVES） complicated with mesangial proliferative glomerulonephritis（ MsPGN） in children,and discusse the relationship between them. Method： The clinical data,auxiliary examination,renal biopsy pathology results of 24 LRVES complicated with MsPGN（ Case group）） and 28 children with simple LRVES（ control group） were retrospectively analyze. Compared the differences between the two groups in age,gender,course of disease,urinary red blood cell morphology,24 hours urine protein quantitative,urine and blood IgG,IgA,IgM,IgG,C3 levels,and the ratio of the diameter（ D / N） of the left renal vein expansion section（ D）and the narrow section in the front of it（ N）. Result： The age,gender,course of disease,blood Ig A,Ig M and Ig G,C3 levels,and the D / N value of two groups has no statistical difference（ P〉0. 05）. Compared with control group,the form of most urinary red blood cells in case group was polymorphism,and 24 hours urine protein quantitative and urine Ig G rise significantly,the difference has statistical significance（ P〈0.05）; Case group＇s renal biopsy were Ms PGN and in control group renal biopsy were glomerular minor lesion.Conclusion： When polymorphic red urine,proteinuri appearing in LRVES children especially urine protein content is high,and with non-selective proteinuria,should considering LRVES combine with glomerular,especially Ms PGN,and adopt renal biopsy early for diagnosis.

关 键 词：左肾静脉受压综合征 系膜增生性肾小球肾炎 儿童 肾活检 

分 类 号：R726.9[医药卫生—儿科]