摘要
目的:探讨儿童隐匿性肾炎的临床和肾组织病理改变特点及其关系。方法:回顾性分析肾活检的323例隐匿性肾炎患儿的临床和肾组织病理改变情况。结果:323例隐匿性肾炎患儿中,单纯性血尿229例,单纯性蛋白尿19例,血尿伴蛋白尿75例。肾组织病理改变类型包括:轻微病变103例(31.89%)、基本正常74例(22.91%)、IgA肾病(IgAN)73例(22.60%)、薄基底膜病(TBMN)27例(8.36%)、系膜增生性肾炎(MsPGN)18例(5.57%)、局灶增生性肾炎(FPGN)10例(3.10%)、膜性肾病(MN)8例(2.48%)、局灶节段肾小球硬化(FSGS)8例(2.48%)、微小病变(MCD)1例(0.31%)、IgM肾病(IgMN)1例(0.31%)。单纯性血尿组中肾组织结构基本正常的比例较血尿伴蛋白尿组明显偏高(P<0.01);血尿伴蛋白尿组中IgAN的比例高于单纯性血尿组和单纯性蛋白尿组(分别P<0.01、P<0.05)。IgAN的Lee分级:单纯性血尿组中Ⅰ、Ⅱ级85.00%,Ⅲ级及以上15.00%;血尿伴蛋白尿组中Ⅰ、Ⅱ级58.10%,Ⅲ级及以上41.90%,明显高于单纯性血尿组(χ2=6.47,P<0.05)。结论:儿童隐匿性肾炎的病理以轻微病变、基本正常、IgAN为常见表现,血尿伴蛋白尿患儿病变较单纯性血尿患儿为重。
Objective： To investigate the clinical and renal pathologic features of asymptomatic hernaturia and/or proteinuria in children and the relationship between them. Methods：A retrospective review of 323 cases of asymptomatic hematuria and/or proteinuria who had been performed renal biopsy within 10 years （ 1995 to 2005） were conducted to analyse their clinical manifestations and renal pathologic features, Results： In 323 children with asymptomatic hematuria and/or proteinuria, there were 229 children with isolated hematuria, 19 with asymptomatic proteinuria and 75 with asymptomatic hematuria and proteinuria. Among the pathologic changes of their nephridial tissue, minor abnormalities was found in 103 cases （31.89%）, normal biopsies in 74 cases （22.91%）, IgA nephropathy（IgAN） in 73 cases（22.60 % ）, thin basement membrane nephropathy （TBMN） in 27 cases（8.36% ）, mesangial proliferative glomerulonephritis（MsPGN） in 18 cases（5.57% ）, focal proliferative glomerulonephritis（FPGN） in 10 cases （3.10%） ,membranous nephropathy（MN） in 8 cases（2.48% ） ,focal segmental glomerulosclerosis（FSGS） in 8 cases（2.48% ） ,minimal change（MCD） in 1 case（0.31%） and IgM nephropathy（IgMN） in 1 case（0.31%）. The proportion of normal biopsies in the isolated hematuria group was higher than that in the asymptomatic hematuria and proteinuria group（ P 〈0.01）; the proportion of IgAN in the asyrnptomatic hematuria and proteinuria group was higher than that in the isolated hematuria group and that in the asymptomatic proteinuria group （P〈 0.01, P 〈 0.05 respectively）. According to Lee grading, grade Ⅰ and Ⅱ were found in 85 % of the IgAN children with isolated hematuria, but in 58.10% of the IgAN children with asymptomatic hematuria and proteinuria, the others were grade Ⅲ or above; there was significant difference between the above two groups（x^2 = 6.47, P 〈 0.05）. Conclusion： The results support that the main pathologic changes of asymptomatic hematuria and/or proteinuria in children are minor abnormalities, normal and IgAN;and the pathogenetic changes in asymptomatic hematuria and proteinuria group is more serious than that in isolated hernaturia group.
出处
《中国中西医结合肾病杂志》
2007年第2期87-89,共3页
Chinese Journal of Integrated Traditional and Western Nephrology
关键词
隐匿性肾炎
儿童
病理
临床
Asymptornatichematuriaand/orproteinuria Children Pathology Clinic
