儿童孤立性血尿临床、病理及血红细胞膜电荷变化的观察

Clinical and Pathology Analysis and Charge of Red Cell in Children with Isolated Hematuria

目的：探讨孤立性血尿患儿临床、病理及血红细胞膜电荷变化的意义。方法：总结78例孤立性血尿息儿的临床资料，对其临床、病理特征进行分析。以红细胞膜Alcian蓝结合量为指标观测孤立性血尿患儿及26例正常儿童红细胞膜电荷量。结果：（1）发病年龄在5～10岁者占90．6％，9月～次年3月为高发病期，发病率占80．32％；感染仍是主要诱因（37．18％），临床上以急性肾炎最常见（34．62％）；（2）IgA肾病是小儿孤立性血尿最常见的病理改变，占35．90％；（3）患儿红细胞膜Alcian蓝结合量及其表面主要阴离子涎酸含量较正常儿童明显降低。结论：（1）孤立性血尿患儿其病因、病理改变多样，需持续追踪观察，必要时需肾穿刺以明确诊断；（2）孤立性血尿患儿其血红细胞膜负电荷下降可能参与了血尿的发生、发展过程。

Objective：To investigate the clinical and pathology analysis and the charge of red cell in children with isolated hematuria. Method：The clinical and pathology characteristics were retrospectively analyzed in 78 patients with isolated hem. aturia which were in hospital. The changes of charge on the surface of red cell was determined in 78 patients and 26 controls by Aleian Blue（AB）binding amount. Results： （1）The maiority age of onset in patients was 5-10 years and the percentage was 90. 6%. 80. 32% patients occurred from September to March of second year. Infection was the main occasion factor（37.18%） still. The acute nephritis was the most constant clinical manifestation（34.62%）. （2）The main pathological type was IgA nephropathy （35.90%）. （3）The AB binding amount and sialie acid （the main negative charge substance） on the surface of red cell in patients was dereased than the control group. Conclusions： （1）Because of multiplicity in the pathogeny and pathology in children with isolated hematuria,the patients are required persistent observation indispensable of renal biopsy. （2）The descend of ngative charge maybe participated in hematuria onset and development.