摘要
目的 探讨小儿原发性膜性肾病与乙肝相关性膜性肾病的临床病理特点及其相互关系。方法 对我院经肾活检确诊为膜性肾病的63例小儿病例 ,其中乙肝相关性膜性肾病 48例 ,原发性膜性肾病 15例。分析比较二者临床表现和肾病理特点。结果 小儿乙肝相关性膜性肾病以 10岁以下幼儿多见 ,72 9% ( 3 5 / 48)伴有不同程度血尿 ,16 7% ( 8/ 48)可见血清补体下降 ,肾病理 95 8% ( 4 6/ 48)有系膜细胞增生 ,免疫荧光 41 7% ( 2 0 / 48)呈“满堂亮”表现 ,肾组织表面抗原均阳性 ;而原发性膜性肾病以 10岁以上年长儿多见 ,较少伴有血尿、血清补体下降及系膜细胞增生等 ,免疫荧光无“满堂亮”表现 ,肾组织表面抗原均阴性。结论 小儿乙肝相关性膜性肾病和原发性膜性肾病在年龄分布、临床表现及肾病理方面有诸多不同点 。
Objective To discuss the clinically pathological characteristics of primary membranous nephropathy and hepatitis B related membranous nephropathy and their relation in children.Methods Sixty-three child cases with membranous nephropathy diagnosed by renal biopsy were summarized, among which there were 48 cases of hepatitis B related membranous nephropathy, and 15 of primary membranous nephropathy. The clinical manifestation and renal pathological characteristic were compared between the two types of membranous nephropathy. Results Hepatitis B related membranous nephropathy was common in those who were younger than 10 year old, and other characteristics of this type were listed as follow: hematuria in 72.9% (35/48) of the cases, serum complement decrease in 16.7% (8/48), mesangium cell proliferation in 95.8% (46/48), and immunofluorescence's 'all bright' in 41.7% (20/48). Hepatitis B surface antigen in renal tissue was positive in all the 48 cases. As for primary membranous nephropathy, most of the 15 cases were elder than 10 year old with little hematuria, complement decrease, and mesangium cell proliferation. There were neither immunofluorescence's 'all bright' nor positive hepatitis B surface antigen in renal tissue. Conclusion There are some differences in age, clinical manifestation and renal pathology between primary membranous nephropathy and hepatitis B related membranous nephropathy in children, which is helpful to differential diagnosis.
出处
《临床军医杂志》
CAS
2004年第5期20-21,共2页
Clinical Journal of Medical Officers
关键词
原发性膜性肾病
乙肝相关性膜性肾病
临床表现
病理改变
primary membranous nephropathy
hepatitis B related membranous nephropathy
clinical manifestation
pathology
