摘要
目的比较不同比例新月体的紫癜性肾炎患者的临床及病理特征。方法选取本院2012年至2017年经肾穿刺活检确诊的紫癜性肾炎患者(新月体形成率<50%),根据新月体形成率进行分组(A组:新月体形成率<10%,B组:新月体形成率10%～24%,C组新月体形成率>24%～49%),比较各组的流行病学、临床表现、实验室检查及病理特征。结果三组性别、年龄、糖尿病发病率差异无统计学意义(P>0.05),C组高血压发病率明显高于其他两组,差异具有统计学意义(P<0.05)。三组患者发病时呕血、腹痛、关节痛发生率,三组比较差异无统计学意义(P>0.05)。浮肿及肉眼血尿发生率比较,C组明显高于其他两组。C组患者中以肾病综合征起病的患者比率最高(38.8%),与其他两组比较差异有统计学意义(P<0.05)。三组患者24 h尿蛋白定量、尿红细胞、嗜酸性粒细胞及CRP、IgE差异无统计学意义(P<0.05),C组血肌酐、BUN及LDL水平明显升高,GFR和白蛋白水平明显降低,与其他两组比较,差异具有统计学意义(P<0.05)。肾脏病理检查:C组间质小管病变、系膜细胞增生及C1q沉积水平明显高于其他两组,差异具有统计学意义(P<0.05)。结论紫癜性肾炎中,随着新月体比例的升高,肾功能及肾脏病理改变逐步加重,因此新月体对紫癜性肾炎的预后具有重要意义。
Objective Comparison of clinical and pathological features of Henoch-Schonlein purpura nephritis with different proportions of crescent. Methods Patients with Henoch Schonlein nephritis diagnosed by renal biopsy in our hospital from 2012 to 2017 （ proportions of crescent 〈 50% ） were enrolled and grouped according to the rate of crescent formation （A group： crescent formation rate 〈 10% ;B group： 10% - 24% ; C group ： 〉 24% - 50% ） , their epidemiological , clinical manifestations, laboratory examination ,clinicopathological features were compared. Results There was no significant difference between the three groups in sex, age and incidence of diabetes （P 〉 0. 05 ）. The morbidity of hypertension in C group is higher than others （ P 〈 0. 05 ）. There were no different in the incidence of hematemesis, abdominal pain, joint pain in the three groups （P 〉0. 05 ） , while the incidence of edema and gross hematuria was significantly higher in group C than others. There were more patients had Nephritic syndrome （38.8%） in C group than the other groups （P 〈 0. 05）. There was no significant difference in 24 h urinary protein, C-reactive protein （CRP）, urine red blood cell, eosinophil granulocyte and immunoglobulin E （IgE） in the 3 groups. The levels of serum creatinine, blood urea nitrogen （ BUN）, and low density lipoprotein （LDL） increased significantly in group C, and the level of glomerular filtration rate （GFR） and albumin decreased significantly（P 〈 0. 05 ）. The tubulointerstitial lesions, mesangial cell proliferation and deposition of C lq levels, C group was significantly higher than the other two groups （ P 〈 0. 05 ）. Conclusions In Henoch Sch^nlein purpura nephritis, with the increase of the proportion of the crescent body, the renal function and pathological changes of the kidney are gradually aggravated. Therefore, the crescent is important for the pronosis of Henoch Schonlein purpura nephritis.
作者
姜雪
杜园园
陈洪宇
Jiang Xue, Du Yuanyuan, Chen Hongyu(Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310000, China)
出处
《中国医师杂志》
CAS
2018年第3期360-363,共4页
Journal of Chinese Physician
基金
国家自然科学基金(81373631)~~
