成人紫癜性肾炎54例临床表现及病理分析

The clinical manifestation and pathological analysis of 54 Adult Henoch-Schonlein Purpura Nephritis

目的:探讨成人紫癜性肾炎(HSPN)患者临床表现、病理特点及其相关性,以提高对成人HSPN的认识。方法:回顾性总结南京军区福州总医院肾内科42例和六安市人民医院肾内科12例,共54例12岁以上HSPN住院病例的临床与病理分型关系分析。结果:有诱因发作者20例(37.0%),Uab型患者比例最高,占27例(50.0%);病理Ⅱ级23例(42.6%)、Ⅲ级23例(42.6%);尿蛋白程度的加重,病理损害加重。结论:紫癜性肾炎的临床表现趋向多样化,随着年龄的增长、尿蛋白程度的加重、出现肾功能不全者,病理损害重;反复肉眼血尿和表现为急进性肾炎者病理损害重;继发高血压虽少见,但病理损害偏重;合并关节痛患者,病理损害偏轻,合并腹痛伴有消化道出血患者病理损害偏轻。

Objective： It discusses the clinical manifestation, pathological characteristics and their relativity from the adult patients of HSPN in order to raise awareness of adult HSPN. Methods： review and summarize the clinical and pathological typing relationships analysis from 54 cases patients over 12 years of old of HSPN, including 42 cases from Kidney Medicine in Fuzhou General Hospital of Nanjing Military Command and 12 cases from Kidney Medicine in Luan People＇s Hospital. Results： There are 20 cases outbreaker with inducement （37. 0%）; the rate of Uah-type patient is the highest with 27 cases （50.0%）; 23 eases of II-level of pathology （42.6%）; 23 cases of III-level of pathology （42.6%）; the higher of Urine Protein＇s degree, the more serious of pathology＇s damage. Conclusion： The clinical manifestation of HSPN tends to be diversified. The pathological damage will become serious with the growth of age, the higher of Urine Protein＇s degree and unsoundness of kidney function. The pathological damage will become serious with the iterative naked eye, hematuria and nephritis with the manifestation. The pathological damage tends to be serious even though secondary hypertension seldom appears. The pathological damage tends to be serious to the complicated arthralgia patients. The pathological damage tendsto be unserious to the patients of complicated bellyache with alimentary canal hemorrhage.