中国北方地区儿童肾小球疾病流行病学特点及病理类型分布特点

The Feature of Epidemiology and Pathological Type Distribution of nephritis in Children in the North Area of China

目的 了解我国北方地区儿童肾小球疾病的流行病学特点和病理类型分布特点。方法 分析我院1983年1月～1997年12月间在本院住院并经肾活检确诊的肾小球疾病的患儿。结果 在本文1361例确诊为肾小球疾病患儿中,男性917例,女性444例,男∶女=2∶1;平均年龄9.8±4岁(4月～17岁);原发性肾小球疾病中占84.64％,继发性肾小球疾病占15.14％,遗传性肾病占0.22％。在1152例原发性肾小球疾病中,发病率最高者为系膜增生性肾炎,占34.6％,其次为微小病变和轻微病变,占17.8％。在206例继发性肾小球疾病中,紫癜性肾炎发病率最高,占85.4％,其次是狼疮性肾炎,占11.7％。原发性肾小球疾病高发年龄段在7～12岁,占32.4％,继发性肾小球疾病的高发年龄段在12～17岁,占43.2％,遗传性肾病多在3岁以后发病而就医。各年龄组原发性肾小球疾病的发病率均明显高于继发性肾小球疾病组(P<0.01),且男性明显高于女性(P<0.01)。在继发性肾小球疾病中,性别无显著差异。但在狼疮性肾炎,女性明显多于男性(P<0.01)。结论 原发性肾小球疾病是儿童最常见的肾小球疾病,男性多发,高发年龄在7～12岁。最常见的病理类型是系膜增生、微小病变和轻微病变;继发性肾小球疾病以紫癜性肾炎最常见,无性别差异,高发年龄在12～17岁。

Objective To Study the feature of epidemiolohy and pathological type distribution of nephritis in children in north area of China. Methods Review the renal disease of children diagnosed by renal biopsy in our hospital from 1983. 1 to 1997. 12. Results In the 1 361 cases of patients, male is 917 cases and female is 444 cases, male: female is 2 :1, age from 4month to 17 year old (mean 9. 8±4). The primary nephritis group take 84.64 %, second nephritis group take 15.14% and hereditary nephritis group take 0.22% in the 1 361 cases of nephritis. In the 1152 cases of primary nephritis, the highest morbidity is mesangial proliferation glomerulonephritis ( GN), it take 34.64% , the second is minimal change disease(MCD)and slight pathological changes,it take 17.8% . In the 206 cases of second nephritis, Henoch-Schonlein purpura nephritis(HSN) morbidity is the highest, it is 85.4%, the next is Lupus nephritis( LN), it take 11.7%. The age of 7 to 12 year old take the highest morbidity in primary nephritis, it take 32. 4% , and in the hereditary nephritis group, the disease mostly come on after 3 year old. The morbidity in primary nephritisis obviously higher than the second nephritis group at each age stage( P < 0.01), and the male is higher than the female( P < 0. 01). It is not significnt differences on sex in the second nephritis group. But in the Lupus nephritis group, female is obviously more than male( P < 0. 01) . Conclusion Primary nephritis is the mostly common nephritis, and the morbidity is higher in male, the higher morbidity is at age of 7 to 12 year old. the common pathological type is mesangial proliferation CN, MCD and slight pathological change, HSN is the mostly common nephritis in second nephritis, there is no differences and the higher morbidity is ant 12 to 17 year old.