摘要
目的研究紫癜性肾炎(HSPN)患儿临床表现与病理改变的关系及疾病转归。方法分析42例HSPN患儿的临床和病理改变,其中40例进行血管紧张素转换酶(ACE)基因检测,并进行随访。结果病理表现Ⅰ级9例,Ⅱ级21例,Ⅲ级12例,未见Ⅳ级及Ⅳ级以上病例。临床表现为孤立性血尿、孤立性蛋白尿病理为Ⅰ、Ⅱ级,血尿和蛋白尿病理为Ⅰ～Ⅲ级,肾病综合征型病理为Ⅱ、Ⅲ级,且肉眼血尿多见于Ⅱ、Ⅲ级患儿;ACE基因DD型肾脏病理损伤重。结论HSPN临床表现不能预测肾脏病理形态改变,但病理损伤越重蛋白尿越重。肉眼血尿和蛋白尿可作为早期肾活检指征;ACE基因DD型肾脏病理损伤重;近期预后良好。
Objective To study the relationship of clinical manifestation and pathological changes and prognosis in Henoch-Schonlein purpura nephritis（HSPN）in children.Methods Clinical and pathological characteristics of 42 children with HSPN were analysed.Among them,40 children were detected of angiotensin-convertion enzyme（ACE）gene and had been followed up.Results Among them,there were 9 cases of level Ⅰof pathological types,21 cases of level Ⅱ,12 cases of level Ⅲ,but no cases of level Ⅳ.Ⅰand Ⅱ level were found in those cases of clinical manifestation with solitary hematuria and albuminuria.Pathological grades were Ⅰ,Ⅱ and Ⅲ levels in the cases of hematuria and albuminuria.Pathological types of nephrotic syndrome（NS）were Ⅱ and Ⅲ level,which were of more gross hematuria than those of other grades.ACE gene DD had serious pathological damnification.Conclusions Change of pathology cannot only be anticipated by clinical manifestation of HSPN.But if pathological damnification gets more serious,the albuminuria gets more serious.Gross hematuria and albuminuria can serve as indicators of biopsy.NS of ACE DD type have serious pathological damnification.Children with HSPN has favourable prognosis in the future.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2007年第17期1313-1314,共2页
Journal of Applied Clinical Pediatrics
关键词
过敏性紫癜
肾炎
临床
病理
Henoch-Schonlein purpura
nephritis
clinic
pathology
