小儿过敏性紫癜肾炎的临床病理与预后分析

Clinical Pathology and Prognosis of Henoch-Schonlein Nephritis in Children

目的探讨小儿过敏性紫癜肾炎的临床、病理与预后的关系。方法分析36例过敏性紫癜肾炎患儿的临床病理变化与预后的关系,了解临床病理对预后的影响。结果小儿过敏性紫癜肾炎的预后与患儿的临床病理相关,临床分型中以急性肾炎型和肾病综合征型为主,孤立性血尿或孤立性蛋白尿型及血尿和蛋白尿型预后较好,急性肾炎型预后好于肾病综合征型;病理分级以II～III级多见,I级和II级的治愈率明显高于III级和IV患者,两组比较有显著性差异(P<0.05);肾小管-间质改变主要为+级和++级,肾小管-间质病变程度与预后显著相关(r=0.766,P<0.01);临床和病理综合分型更能反应患者的预后,与预后显著相关(r=0.855,P<0.01)。结论小儿过敏性紫癜肾炎的预后与患儿的临床病理改变相关,临床和病理综合分型更能反应患者的预后。

Objective To study the relationship between the clinical and pathological features and prognosis in children with Henoch-Schonlein purpura nephritis. Methods Retrospectively analyze the clinical pathological features and prognosis of 36 children with Henoch-Schonlein purpura nephritis, and investigate the relationship between them. Results The prognosis of Henoch-Schonlein purpura nephritis in children was associated with the clinical pathological features. In clinical classification, type Ⅰ and Ⅱ usually had a good prognosis, and the prognosis of type Ⅲ was better than that of type IV, In pathological grading, the recovery rate for grading I and II was better than that for gradingⅢ and Ⅳ （P〈O. 05）, Pathological changes in nephric tubule and interstitium were significantly correlated with the prognosis of HenochSchonlein purpura nephritis.（r=0.766, P〈O. O1）. Classification combining the clinical and pathological feature significantly correlated the prognosis, and it was better than other classifications in representing the prognosis of Henoch-Schonlein purpura nephritis （r=0.855, P〈O. O1）. Conclusions The prognosis of Henoch-Schonlein purpura nephritis in children correlated with the clinical and pathological features, Classification combining the clinical and pathological feature was a good predictive factor for the prognosis.