HSPN患儿蛋白尿、C3沉积与病理分级的相关性分析  

Correlation between proteinuria,C3 deposition and pathological grading of children with HSPN

作　　者：朱晓东[1] 张晓苹[1] 张颖玮[1] 石书梅[1] 

机构地区：[1]济南军区总医院肾内科,山东济南250031

出　　处：《中国妇幼健康研究》2017年第9期1093-1095,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨过敏性紫癜性肾炎(HSPN)患儿尿蛋白严重程度、肾组织补体C3沉积与病理分级的相关性。方法收集济南军区总医院2011至2016年确诊为HSPN的45例患儿的临床资料,通过患儿的临床分型、免疫复合物沉积类型等临床表现分析尿蛋白严重程度、肾组织补体C3沉积与HSPN病理分级的相关性。结果在45例患儿中13例(28.89%)患儿为单纯性血尿或蛋白尿,22例(48.89%)患儿为血尿和蛋白尿,10例(22.22%)患儿为肾病综合征型,无急性肾炎型、急进性肾炎型和慢性肾炎型患儿。病理分级统计显示,Ⅰ级患儿3例(6.67%),Ⅱ级患儿20例(44.44%),Ⅲ级患儿22例(48.89%),无Ⅳ级患儿,相关性检验显示蛋白尿的严重程度与病理分级显著相关(rs=0.43,P<0.01)。免疫复合物沉积类型统计结果显示,IgA+IgM沉积为主要沉积类型(27例,60.00%),其次为IgA+IgM+IgG沉积(12例,26.67%)和IgA沉积(6例,13.33%),不存在IgA+IgG沉积、IgM沉积以及无Ig沉积患儿;伴肾组织补体C3沉积有35例(77.78%),免疫复合物沉积类型在病理分级上的分布差异无统计学意义(χ~2=26.95,P>0.05),肾组织补体C3沉积与病理分级正相关(rs=0.38,P<0.01)。结论 HSPN的病理分级与患儿的蛋白尿程度、肾组织补体C3沉积相关,蛋白尿严重患儿的病理分级相应偏高,伴有肾组织补体C3沉积患儿的病理分级也相应偏高。Objective To explore the correlation between urinary protein severity,renal complement C3 deposition and pathological grading in children with henoch-schonlein purpura nephritis（ HSPN）. Methods Clinical data of 45 children diagnosed with HSPN in General Hospital of Jinan Military Area from 2011 to 2016 were collected. The correlation between urinary protein severity,complement C3 deposition and HSPN pathological grading was analyzed by clinical manifestations such as clinical classification and immune complex deposition type. Results Among 45 patients,13（ 28. 89%） children were diagnosed with simple hematuria or proteinuria,22 children（ 48. 89%） with both hematuria and proteinuria,10 children（ 22. 22%） with nephrotic syndrome. No children had acute nephritis,rapidly progressive nephritis or chronic nephritis. Pathological grading statistics showed that 3 children（ 6. 67%） were in grade Ⅰ,20children（ 44. 44%） in grade Ⅱ,22 children（ 48. 89%） in grade Ⅲ and no one was in grade IV. Correlation test showed significant correlation between severity of proteinuria and pathological grading（ rs= 0. 43,P 0. 01）. Immune complex deposition type statistics showed that IgA ＋ IgM deposition was the main deposition type which was in 27 cases（ 60. 00%）,followed by IgA ＋ IgM ＋ IgG deposition in 12 cases（ 26. 67%）,and IgA deposition in 6 cases（ 13. 33%）. No IgA ＋ IgG deposition,IgM deposition or Igdeposition was found in patients. Complement of renal tissue C3 deposition was found in 35 cases（ 77. 78%）. There was no significant difference in distribution of immune complex deposition type in different pathological grades（ χ~2 = 26. 95,P 0. 05）. Renal tissue complement C3 deposition was positively correlated with pathological grading（ rs= 0. 38,P 0. 01）. Conclusion Pathological grading of HSPN is correlated with degree of proteinuria in children and C3 deposition in renal tissue. The pathological grade is higher in children with severe proteinuria as well as in ch

关 键 词：过敏性紫癜性肾炎 儿童 蛋白尿 肾组织补体 病理分级 

分 类 号：R725.5[医药卫生—儿科]