摘要
目的:探讨伴肉眼血尿的儿童原发性Ig A肾病的临床及病理特征。方法:回顾性分析2014年1月至2017年5月在我院肾活检确诊的106例原发性Ig A肾病患儿的资料,比较肉眼血尿组及无肉眼血尿组间的临床及病理特征。结果:肉眼血尿组与无肉眼血尿组比较,年龄、性别、体质量指数、血压、血尿酸水平、血红蛋白水平、贫血发生率、蛋白尿水平、血清白蛋白、血清Ig M、补体C3、补体C4水平差异无统计学意义(P>0.05)。肉眼血尿组患儿更容易伴随前驱感染且病程更短,其e GFR明显低于无肉眼血尿组,分别为(153.81±72.30)m L/(min·1.73 m^2)及(182.92±54.65)m L/(min·1.73 m^2),而血Ig A、Ig G明显高于无肉眼血尿组,分别为(2.69±0.93)g/L、(9.26±3.41)g/L及(1.93±0.62)g/L、(6.67±2.56)g/L。肉眼血尿组患儿出现新月体的可能性(56.8%)要大于无肉眼血尿组(25.8%)。结论:伴肉眼血尿的儿童原发性Ig A肾病患儿临床表现较重,容易出现肾功能下降、大量蛋白尿等表现,其肾脏活动性病变程度明显重于无肉眼血尿的患儿且更容易出现新月体,而在慢性化病变方面比较两组差异无统计学意义。
Objective： To probe into the clinical and pathological features of primary Ig A nephropathy in children with gross hematuria.Methods： Retrospective analysis was conducted on 106 patients with primary Ig A nephropathy admitted into our hospital from Jan. 2014 to May 2017. The clinical and pathological features of gross hematuria group and no gross hematuria group were compared. Results：There was no statistical difference in age,gender,body mass index,blood pressure,blood uric acid level,hemoglobin level,anemia incidence,proteinuria level,serum albumin,serum Ig M,complement C3 and complement C4 levels in the gross hematuria group and no gross hematuria group（ P0.05）. Children with gross hematuria were more likely to be associated with pre-infection and had a shorter course of disease. The e GFR was significantly lower in gross hematuria group [（153.81±72.30） m L/（ min·1.73 m2）]than that in no gross hematuria group [（182.92±54.65） m L/（ min·1.73 m2）]; yet the blood Ig A and Ig G of gross hematuria group [（2.69±0.93） g/L,（9.26±3.41） g/L] were significantly higher than those of no gross hematuria group [（1.93±0.62） g/L,（6.67± 2.56） g/L]. The crescents in gross hematuria group（56.8%） was greater than that in no gross hematuria group（ 25.8%）. Conclusion： Children with primary Ig A nephropathy with gross hematuria have a severe clinical manifestation,which is prone to renal function decline,massive proteinuria,etc. The degree of renal activity is significantly higher than that of children without gross hematuria and is more prone to crescentic,yet there is no significant difference between two groups in the comparison of chronic lesions.
作者
寻劢
李志辉
段翠蓉
张翼
吴天慧
丁云峰
康志娟
Xun Mai;Li Zhihui;Duan Cuirong;Zhang Yi;Wu Tianhui;Ding Yunfeng;Kang Zhijuan(Hunan Children＇s Hospital,Hunan Changsha 410007,China)
出处
《儿科药学杂志》
CAS
2018年第10期12-16,共5页
Journal of Pediatric Pharmacy
基金
湖南省科技创新平台与人才计划
编号2016SK4004
关键词
IGA肾病
肉眼血尿
临床特征
病理特征
IgA nephropathy
grossc hematuria
clinical features
pathological features
