成人紫癜性肾炎肾小管间质损害的临床病理相关分析  

Clinicopathologic analysis of renal tubular interstitial lesions in adults with Henoch-Sch?nlein

作　　者：张晶 沈清[1] ZHANG Jing;SHEN Qing(Department of Nephrology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院肾脏内科

出　　处：《现代医药卫生》2019年第19期2956-2960,共5页Journal of Modern Medicine & Health

摘　　要：目的探讨成人紫癜性肾炎(HSPN)合并肾小管间质损害的临床病理特点及其相关性。方法将2011年1月至2018年6月该科收治的76例经肾活检确诊为成人HSPN患者分为无肾小管间质损害组(n=12)和肾小管间质损害组(n=64),对比2组临床、病理特点,分析肾小管间质损害程度与临床及病理参数间的相关性。结果2组的血尿素氮(BUN)、血清肌酐(Scr)、尿酸(UA)、血清胱抑素C(CysC)、24h尿蛋白定量(24-UP)、三酰甘油、内生肌酐清除率、肾小球病理分级、肾小球硬化、新月体形成、基膜病变及肾内动脉硬化积分比较,差异均有统计学意义(P<0.05)。肾小管间质病理分级与年龄、病程、BUN、Scr、UA、CysC、24-UP、肾小球病理分级、肾小球硬化、基膜病变、系膜细胞增生呈正相关(P<0.05),与内生肌酐清除率呈负相关(P<0.05)。结论合并肾小管间质损害的成人HSPN临床指标及肾脏病理损害更重,提示肾小管间质损害可能为预测成人HSPN进展及预后的因素之一。Objective To analyze the characteristics and relationship of clinic and pathology in adult Henoch-Sch nlein(HSPN)purpura nephritis with or without tubulointerstitial lesions.Methods A total of 76 adults with HSPN purpura nephritis diagnosed by renal biopsy admitted to the department from January 2011 to June 2018 were divided into no tubular interstitial damage group(n=12)and tubular interstitial damage group(n=64).The clinical and pathological characteristics of the two groups were compared to analyze the correlation between the degree of tubulointerstitial damage and the clinical and pathological parameters.Results The difference of blood urea nitrogen(BUN),serum creatinine(Scr),uric acid(UA),serum cystatin C(CysC),24 hours urinary protein quantity(24-UP),triglyceride levels,creatinine clearance rate,glomerular pathological grade,glomerulosclerosis,crescent formation,basement membrane lesions and intrarenal arteriosclerosis score between the two groups were statistically significant(P<0.05).Renal tubular interstitial pathological grading was positively correlated with age,course of disease,BUN,Scr,UA,CysC,24-UP,glomerular pathological grading,glomerular sclerosis,basal membrane lesions,and mesangial cell proliferation(P<0.05),and negatively correlated with endogenous creatinine clearance rate(P<0.05).Conclusion The clinical indexes of adult HSPN with renal tubulointerstitial damage and renal pathological damage are more severe,suggesting that renal tubulointerstitial damage may be one of the factors to predict the progression and prognosis of adult HSPN.

关 键 词：肾炎/病因学 紫癜 过敏性/并发症 肾小管 成人 紫癜性肾炎 肾小管间质损害 临床病理 

分 类 号：R554.6[医药卫生—血液循环系统疾病]