儿童紫癜性肾炎病理分级与临床表现相关性分析.docVIP

儿童紫癜性肾炎病理分级与临床表现相关性分析 　　doi：10.3969/j.issn.1007-614x.2014.4.71 　　摘 要 目的：探讨儿童紫癜性肾炎肾脏病理分级与临床表现之间的联系。方法：收治紫癜性肾炎并行肾穿刺活检患儿35例，对其进行病理分级与临床表现相关性分析。结果：病理分级主要集中在Ⅱb级（28.6%）和Ⅲa级（37.1%），临床分型以血尿和蛋白尿型（45.7%）为主，免疫病理分型集中表现IgA+IgM沉积型（37.1%）和IgA+IgG+IgM沉积型（40%）。血Ccr越低，病理分级越重（P0.05），尿红细胞计数、24小时尿蛋白定量越高，病理分级越重（P0.05）。结论：临床分型为肾病综合征型，则病理分级较重，但病理分级与临床分型不完全一致。病理分级较重时，IgA+IgG+IgM沉积型所占比例增加，但病理分级与免疫病理分型分布间未发现关联性。血Ccr、尿红细胞计数、24小时尿蛋白定量与病理分级有相关性，而Cys-C与病理分级的关系有待于进一步探讨。 　　关键词 儿童 紫癜性肾炎 病理 临床表现 　　Correlation analysis of pathological grading of children with Schonlein purpura nephritis and clinical manifestations 　　Zhang Xiaoyuan1，Fang Qiwei2 　　Department of pediatric medicine of Shanxi Medical University of（Taiyuan City，Shanxi Province），0300011 　　Renal Department of Internal Medicine of Childrens Hospital of Shanxi Province（Taiyuan City，Shanxi Province）2 　　Abstract Objective：To explore the correlation analysis of pathological grading of children with Schonlein purpura nephritis and clinical manifestations.Methods：We selected 35 children with purpura nephritis checked with renal needle biopsy from 2012 August to 2013 November.We analyzed the correlation between pathological grading and clinical manifestations.Results：Pathological grade were largely ⅡB grade（28.6%）and Ⅲa grade（37.1%）.Clinical type was mainly the hematuria and proteinuria type（45.7%）.Immune pathological type were mainly IgA+IgM sedimentary type（37.1%）and IgA+IgG+IgM deposition type（40%）.Blood Ccr was lower，more severe pathological grading（P0.05）.Urine red blood cell count and 24 hour urinary protein quantitative were higher，more severe pathological grading（P0.05）.Conclusion：Pathological grading of nephrotic syndrome was serious.But the pathological grading and clinical typing was not completely consistent.When the Pathological grading was heavy，the proportion of IgA+IgG+IgM sedimentary type increased.But the pathological grading and immune pathological type distribution found no association.Blood Ccr，urine red blood cell co