93例紫癜性肾炎临床病理分析  

Clinical and pathological manifestations of 93 cases of Henoch-Schonlein purpura nephritis

作　　者：郝敏[1] 李菲[1] 王晨[2] 王利华[3] 牛丹 申宁宁[1] Hao Min;Li Fei;Wang Chen;Wang Lihua;Niu Dan;Shen Ningning(Shanxi Medical University,Taiyuan 030000,Chin)

机构地区：[1]山西医科大学,太原030000 [2]山西医科大学第二医院病理科 [3]山西医科大学第二医院肾内科

出　　处：《国际移植与血液净化杂志》2018年第3期19-23,共5页International Journal of Transplantation and Hemopurification

基　　金：山西省自然基金项目（2015011093）

摘　　要：目的探讨紫癜性肾炎患者临床与病理的相关性。方法纳入山西医科大学第二医院确诊为紫癜性肾炎的93例患者，对其临床资料与肾脏病理损伤进行比较。结果（1）93例紫癜性肾炎患者中29例（31．2％）起病前有明显诱因，以感染多见。发病季节以春季为主。好发人群以〈20岁患者多见。所有患者均有典型的皮肤紫癜表现，部分患者有腹痛、消化道出血、关节肿痛症状。（2）93例紫癜性肾炎患者中病理分型以Ⅱ型、Ⅲ型多见，分别为30例（32．3％）和60例（64．5％）。87例紫癜性肾炎患者中免疫分型以IgA＋IgM＋IgG型为主，共36例（41．4％）。（3）93例紫癜性肾炎病理分型与年龄（P=0．042）、24h尿蛋白定量（P=0．041）、免疫分型（P=0．011）、IgA沉积强度（P=0．027）呈正相关，与肾小球滤过率（P=0．012）呈负相关。结论紫癜性肾炎患者的临床资料（如年龄、24h尿蛋白定量、肾小球滤过率等）与其肾脏病理损伤密切相关，通过对临床资料的分析可以评估肾脏损伤严重程度，对肾活检的选择、疾病的治疗及预后评估有一定指导意义。Objective To investigate the clinical and pathological features of nephritis of Henoch- Schonlein purpura nephritis （HSPN）. Methods Ninety-three cases of HSPN diagnosed in the Second Hospital of Shanxi Medical University were collected and clinico-pathological findings at diagnosis were compared. Results （1） Of all the 93 patients with HSPN, 29 cases （31.2 % ） had obvious predispositions before onset, the most common causes was infection. Spring was the most common season of onset. The vulnerable population was patients whose age was 〈 20 years old. All patients had a typical performance of skin purpura, some patients had abdominal pain, gastrointestinal bleeding, joint edema and pain. （2）The pathological type of 93 patients with HSPN were more common in type Ⅱ and Ⅲ, which were 30 cases （32.3%） and 60 cases （64.5%） ,respectively. The immunopheno type of 87 patients with HSPN was mainly IgA＋ IgG ＋ IgM, （ n = 36, 41.4%）. （3） The pathological type of 93 cases of HSPN was positively correlated with age （ P = 0. 042）, 24-hour urinary protein （ P = 0.041 ）, immunopheno type （ P = 0.011 ）, level of IgA deposition （ P = 0. 027 ） ; negatively correlated with glomerular filtration rate （ P = 0. 012 ）. Condusions The clinical data of HSPN such as age, 24-hour urinary protein, glomerular filtration rate were closely related to the pathological type. Through the analysis of clinical data can assess the severity of renal injury, had a certain significance for the choice of renal biopsy, disease treatment and evaluation of prognostic.

关 键 词：紫癜性肾炎 临床表现 病理分级 

分 类 号：R692.34[医药卫生—泌尿科学]