儿童过敏性紫癜肾炎的临床与病理相关性分析

The relationship of pathologic characteristics and clinical manifestations

目的探讨儿童过敏性紫癜肾炎(HSPN)临床分型与病理改变的关系。方法对34例HSPN患儿进行临床分型、病理分型、免疫组织化学分析。结果临床分型中轻型表现占67.65%,肾病综合征型占29.41%,肾炎型占2.94%。病理分型中以Ⅱ级和Ⅲ级多见,分别占47.06%和41.18%。Ⅱ级中轻型占85.71%,Ⅲ级中轻型占50.00%,肾病综合征型占43.75%。免疫复合物沉积以IgA+IgM沉积者的比例最高,占26.47%,其次为IgA+IgG+IgM+C3,为23.53%。血液中IgA升高和补体C3下降比例分别为8.82%和17.64%。结论过敏性紫癜肾炎随着病理分级的增加,肾病综合征型比例逐渐增加。免疫复合物主要以IgA及合并有其他的免疫复合物的沉积为主,血液中IgA的检测不能反映肾脏免疫复合物沉积情况。

Objective To study the relationship between pathologic characteristics and clinical manifestations as well as immunity complex deposits in children with Henoch Schonlein purpura nephritis（HSPN）.Methods Analysis of clinic diagnosis,pathologic analysis,immunity complex deposits in 34 children of HSPN.Results Clinical features：mild features occupied 67.65%,nephrotic syndrome features occupied 29.41%,glomerulonephritis occupied 2.94%：Ⅱ grade and Ⅲ grade was main kind of pathology change of renal tissues,the rate was 47.06% and 41.18%.There were 85.71% mild case.There were 50.00% mild case and 43.75% was nephrotic syndrome case in the Ⅲ grade pathology change.IgA＋IgM immunity complex deposits was the most common,occupied 26.47%;IgA＋IgG＋IgM＋C3 immunity complex deposits occupied 23.53%.IgA increased 8.82% and C3 decreased 17.64%.Conclusion Mild is mains type in Henoch Schonlein purpura nephritis.The second is type of nephrotic syndrome.The grade of clinic presence has the relationship with pathologic characteristics.IgA and other immunity complex deposits is main complex in kedney tissue,but the change of IgA is less in blood.