病理分级Ⅲ级的儿童紫癜性肾炎临床病理及预后分析  

Analysis of Clinicopathology and Outcome of Childhood Henoch-schonlein Purpura Nephritis Grade Ⅲ

作　　者：林洪洲[1] 付贵[1] 杨青[1] 庄捷秋[1] 

机构地区：[1]温州医科大学附属第二医院育英儿童医院肾内科,温州325027

出　　处：《中国中西医结合肾病杂志》2016年第11期978-980,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然科学基金资助项目(No.81170709);温州市科技局对外科技合作交流项目(No.H20090022)

摘　　要：目的：研究病理分级为Ⅲ级的紫癜性肾炎患儿的临床病理特点及预后。方法：回顾性分析了2005年1月~2013年6月于温州医科大学附属育英儿童医院儿童肾内科住院,经肾活检病理诊断为紫癜性肾炎Ⅲ级患儿资料,比较患儿的临床表现和病理特点,分析了解临床与病理特点之间的关系。结果：（1）HSPN-Ⅲa组29例,HSPN-Ⅲb组23例。HSPN-Ⅲb组患儿的体重校正尿蛋白多于HSPN-Ⅲa组。（2）HSPN-Ⅲb组较HSPN-Ⅲa组肾小管萎缩及间质纤维化、重度系膜增生更为多见,系膜增生程度更为严重。（3）两组患儿在治疗及疾病转归上差异无统计学意义。结论：Ⅲb级HSPN蛋白尿程度及肾小管萎缩、系膜增生更为严重,早期积极予以激素联合免疫抑制剂干预可获得良好的短期疗效。Objective： To investigate the clinicopathogical characteristics and outcome of Henoch- Schonlein purpura nephritis grade Ⅲ in children. Methods： Retrospectively analyzed the clinicopathogy and follow- up data of children whom were biopsy- proven HSPN grade Ⅲ in our hospital from January 2005 to June 2013,and then compared the HSPN grade Ⅲa and Ⅲb. Results：（ 1） In contrast to the 29 cases of HSPN- Ⅲa group,the 23 cases of HSPN- Ⅲb group showed more urine protein corrected by body weight.（ 2） Compared with the HSPN- Ⅲa group,the HSPN- Ⅲb group had more renal tubulointerstitial lesions and severe mesangial proliferative glomerulonephritis.（ 3） The two group showed no statistically significant differences in treatment and outcome.Conclusion： HSPN grade Ⅲb showed severity of proteinuria,renal tubulointerstitial lesions and mesangial proliferative. Immunosuppressant treatment in the early stage of disease is effective for a short term outcome.

关 键 词：紫癜性肾炎 病理 临床表现 

分 类 号：R726.9[医药卫生—儿科]