儿童原发性肾病综合征微小病变型合并小管间质损伤的病理及临床分析  

Pathological and clinical analysis of minimal change primary nephritic syndrome with tubulointerstitial lesions in children

作　　者：石咏琪 王墨[1] 阳海平[1] 张高福[1] 吴道奇[1] 杨琴[1] 钟诚 王安硕 Shi Yongqi;Wang Mo;Yang Haiping;Zhang Gaofu;Wu Daoqi;Yang Qin;Zhong Cheng;Wang Anshuo(Department of Internal Nephrology,Children’s Hospital of Chongqing Medical University/National Demonstration Base of Standardized Training Base for Resident Physicians/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics)

机构地区：[1]重庆医科大学附属儿童医院肾脏内科、国家住院医师规范化培训示范基地、儿童发育疾病研究教育部重点实验室、儿童发育重大疾病国家国际科技合作基地、儿科学重庆市重点实验室,重庆400014

出　　处：《重庆医科大学学报》2020年第5期595-598,共4页Journal of Chongqing Medical University

基　　金：重庆市渝中区科技计划资助项目(编号:2017045)。

摘　　要：目的:探讨儿童微小病变型肾病综合征合并小管间质损伤的临床与病理特点。方法:回顾性分析148例微小病变型肾病(minimal change nephrotic syndrome,MCN)患儿的临床与病理资料,比较MCN合并肾小管间质损伤(tubular interstitiallesion,TIL)的临床与病理特点。结果:小管间质损伤共28例,占比18.9%;小管间质损伤病理改变类型以炎症细胞浸润及小管扩张为主;TIL组患儿病情较Non-TIL组更重,表现为血尿、蛋白排泄增多、肾功能不全及小管功能下降,TIL的发生与肾功能损害密切相关;MCN转归情况与小管间质损伤无明显相关(P>0.05)。结论:随着小管间质损伤的发生,MCN患儿病情加重,小管间质损伤可作为影响MCN进展的重要因素。Objective:To investigate clinical and pathological characteristics of minimal change primary nephrotic syndrome(MCN)with tubulointerstitial lesions(TIL)in children.Methods:Pathological and clinical materials of 148 patients with MCN were retrospec-tively analyzed,and clinical and pathological characteristics of MCN with TIL were compared.Results:A total of 28 patients had TIL,accounting for 18.9%;the main pathological changes of TIL were inflammatory cell infiltration and tubule dilatation.The condition of children in the TIL group were more severe than that in the non-TIL group,with manifestations such as hematuria,increased protein excretion,renal inadequacy,and significantly impaired tubule function,indicating that renal function damage was closely related to development of TIL.MCN outcome was not obviously associated with TIL(P>0.05).Conclusion:With the occurrence of TIL,the con-dition of children with MCN is aggravated,indicating that TIL may be an important factor influencing the progression of MCN.

关 键 词：肾病综合征 肾小管间质病变 临床病理 

分 类 号：R725[医药卫生—儿科]