伴高尿酸血症的儿童IgA肾病临床病理特征分析  

Clinical and Pathological Features of IgA Nephropathy in Children with Hyperuricemia

作　　者：寻劢[1] 李志辉[1] 段翠蓉[1] 张翼[1] 吴天慧[1] 丁云峰[1] 康志娟[1] Xun Mai;Li Zhihui;Duan Cuirong;Zhang Yi;Wu Tianhui;Ding Yunfeng;Kang Zhijuan(Hunan Children's Hospital,Hunan Changsha 410007,China)

机构地区：[1]湖南省儿童医院,湖南长沙410007

出　　处：《儿科药学杂志》2021年第6期4-7,共4页Journal of Pediatric Pharmacy

基　　金：湖南省科技计划项目,编号2016SK4004。

摘　　要：目的:探讨伴高尿酸血症的儿童IgA肾病的临床病理特征。方法:回顾性分析2016年9月至2019年10月在湖南省儿童医院经肾组织活检确诊的131例原发性IgA肾病患儿的资料,分为高尿酸血症组和尿酸正常组,比较两组患儿的临床病理特征。结果:高尿酸血症组31例(23.7%),尿酸正常组100例(76.3%)。高尿酸血症组的高血压发生率及蛋白尿程度高于尿酸正常组,而肾小球滤过率低于尿酸正常组(P均<0.05)。根据牛津病理评分,高尿酸血症组患儿肾间质病变(肾小管萎缩/间质纤维化)比尿酸正常组严重,而肾小球病变程度相当。根据Katafuchi评分,高尿酸血症组患儿肾间质纤维化、炎性细胞浸润及肾血管病变的程度比尿酸正常组严重,而肾小球病变及肾小管萎缩程度相当。结论:伴高尿酸血症的儿童IgA肾病临床表现更严重,主要体现在肾间质病理损伤方面。Objective:To probe into the clinical and pathological features of IgA nephropathy in children with hyperuricemia.Methods:Clinical data of 131 children with primary IgA nephropathy diagnosed by renal biopsy in Hunan Children’s Hospital from Sept.2016 to Oct.2019 were analyzed retrospectively.All children were divided into the hyperuricemia group and the normal group.The clinical and pathological features of two groups were compared.Results:There were 31 cases(23.7%)in the hyperuricemia group and 100 cases(76.3%)in the normal group.The incidences of hypertension and proteinuria in the hyperuricemia group were significantly higher than those in the normal group,while the glomerular filtration rate was significantly lower than that in the normal group(P<0.05).According to Oxford pathological score,the renal interstitial lesions(tubular atrophy/interstitial fibrosis)in the hyperuricemia group were more severe than those in the normal group,while the difference of degree of glomerular lesions was not statistically significant between two groups.According to Katafuchi score,the degree of renal interstitial fibrosis,inflammatory cell infiltration and renal vascular disease in the hyperuricemia group were more severe than those in the normal group,while there was no significant difference in the degree of glomerulopathy and renal tubular atrophy between two groups.Conclusion:The clinical manifestations of IgA nephropathy in children with hyperuricemia are more severe,mainly for the pathological injury of renal interstitium.

关 键 词：儿童 IGA肾病 高尿酸血症 临床病理 

分 类 号：R725.9[医药卫生—儿科]