45例儿童肾脏穿刺活检的临床与病理特征分析  

Analysis of clinical and pathological features of renal biopsy in 45 children

作　　者：贺兼碧 王慧 何柳静 黄芸 潘瑞英 HE Jianbi;WANG Hui;HE Liujing;HUANG Yun;PAN Ruiying(Department of Pediatrics,924th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force,Guangxi Zhuang Autonomous Region,Guilin 541004,China)

机构地区：[1]中国人民解放军联勤保障部队第九二四医院儿科,广西桂林541004

出　　处：《妇儿健康导刊》2023年第4期69-71,87,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210436);广西壮族自治区桂林市科学研究与技术开发计划项目(20190218-9-4)。

摘　　要：目的分析45例儿童肾脏穿刺活检的临床与病理特征。方法收集中国人民解放军联勤保障部队第九二四医院2017年12月至2022年3月收治的45例肾脏穿刺活检患儿的临床和病理资料,分析临床特征与病理类型的关系。结果45例肾脏穿刺活检患儿中,男24例,女21例,男女比例为1.14∶1,发病年龄以6~9岁多见。原发性肾小球疾病(PGD)24例(53.33%),其主要病理类型为微小病变肾病(MCD)8例(33.33%)、IgA肾病5例(20.83%)、足细胞病5例(20.83%)。继发性肾小球疾病(SGD)21例(46.67%),其主要病理类型为过敏性紫癜性肾炎(HSPN)17例(80.95%)、狼疮性肾炎4例(19.05%);SGD年龄分布以6~9岁占比最高,病理类型在各年龄组中构成比差异有统计学意义(P<0.05)。PGD最主要的临床诊断为肾病综合征16例(66.67%),其后依次为尿检异常、急性肾小球肾炎、肾炎综合征,其中肾病综合征患儿病理类型以MCD为主。结论本研究中儿童肾脏疾病的分类以PGD为主,MCD、IgA肾病及足细胞病是PGD的主要病理类型,最常见的临床诊断为肾病综合征;SGD中以HSPN发病率最高。积极行肾活检且早期合理治疗至关重要。Objective To analyze the clinical and pathological features of renal biopsy in 45 children.Methods The clinical and pathological data of 45 children with renal biopsy admitted to 924th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force from December 2017 to March 2022 were collected to analyze the relationship between clinical features and pathological types.Results Among the 45 children with renal biopsy,there were 24 males and 21 females with the ratio of males to females of 1.14∶1,and the age of onset was usually 6-9 years old.There were 24 cases(53.33%)of primary glomerular diseases(PGD),and the main pathologic types were minimal change disease(MCD)in 8 cases(33.33%),IgA nephropathy in 5 cases(20.83%)and podocytopathy in 5 cases(20.83%).There were 21 cases(46.67%)of secondary glomerular diseases(SGD),and the main pathological types were Henoch-Schonlein purpura nephritis(HSPN)in 17 cases(80.95%)and lupus nephritis in 4 cases(19.05%).And the age distribution of SGD was the highest in 6-9 years old,and the composition ratio of pathological types in all age groups had statistical significance(P<0.05).The main clinical diagnosis of PGD was nephrotic syndrome in 16 cases(66.67%),followed by abnormal urine test,acute glomerulonephritis,and nephritis syndrome.The pathological types of nephrotic syndrome were mainly MCD.Conclusion In this study,PGD is the main classification of renal diseases in children.MCD,IgA nephropathy and podocytopathy are the main pathological types of PGD,and the most common clinical diagnosis is nephrotic syndrome.The highest incidence of SGD is HSPN.It is extremely important to conduct renal biopsy actively and early reasonable treatment.

关 键 词：儿童 肾脏穿刺活检 肾小球疾病 病理类型 

分 类 号：R726.9[医药卫生—儿科]