缓解与反复的肾病综合征患儿的病理动态对照分析（29例小儿重复肾活检报告）

THE PATHOLOGICAL STUDY OF REMISSIVE AND RELAPSING NEPHROTIC SYNDROME IN CHILDREN

本文动态对比分析了２０例长期缓解与９例有反复的小儿肾病综合征病理学改变，结果表明缓解组ｌｇＧ，Ｃ３沉积随病情好转而明显减少（Ｐ＜０．０５）。反复组ＩｇＧ沉积下减少，Ｃ３，Ｆｉｂ因病情反复而明显增多（Ｐ＜０．０５）。缓解组ＩｇＧ，Ｃ３，Ｆｉｂ沉积减少程度明显优于反复组（Ｐ＜０．０５～０．００１）。虽然在首次活检时反复组病理改变比缓解组严重，但是缓解组前后的病理形态改善程度明显优于反复组（Ｐ＜０．００１），肾小球病变的消长与肾间质病变具有同步性，小儿肾病综合征病理类型之间具有可变性。因此作者认为，两组病人肾脏对免疫复合物清除能力不同决定了病理学的改变及临床转归，肾间质病变与肾小球病变在发病机理上可能有一定的联系，另外，小儿肾病综合征病理改变是一动态变化的过程，病理学的变化决定了临床表现。

o evaluate the pathological change of remissiveand relapsing nephrotic syndrome (NS) , the repeat re-nal biopsy data was analysed in 20 remissive and 9 re-lapsing NS in children. The results show : IgG and C3deposition is obviously reducing in remission NS (P<0. 05) . in relapse cases , however, IgG is not decreas-ing (P>0. 05) , C3 and fibrinogen deposition signifi-cantly increase (P<0. 05). The reduced level of IgG .C3 and fibrinogen deposition in rernission is more ap-parent than that of relapse (P< 0. 05- 0. 001). Thehistopathological improvement extent in remission ismore evident than that of relapse (P<0. 001). Thepathological types in children with NS is variable. Ithas synchronism that the lesion in glomeruli and renaltubular interstitium. This results suggest that thehistopathological and clinical change is decided bypurging immune complex ability of mesangial cell. It ispossible to relate the golmeruli with renal tubular in-terstitium in the lesion mechanism. It is a developmentprocess in histopathological change of children withNS, the clinical manifestation depend on pathologicalvariation .