30例儿童毛细血管内增生性肾小球肾炎临床和病理分析

Clinical and pathological analysis in 30 children with endocapillary proliferative glomerulonephritis

为了解毛细血管内增生性肾小球肾炎的特殊临床表现,探讨肾穿刺活检术在急性肾小球肾炎中的应用,采用回顾分析法,对30例毛细血管内增生性肾小球肾炎临床、病理进行统计分析。结果显示,临床表现为肾病综合征8例,急性肾功能衰竭8例,IgA肾病6例,急性肾炎6例,隐匿性肾炎2例。病理学表明,以肾病型、肾衰型病变重,分别有不同程度的新月体形成。肾病型有5例免疫荧光示IgG、C3沉积呈“花环状”。提示毛细血管内增生性肾小球肾炎临床表现多样,肾穿刺活检术可明确诊断。强的松龙治疗急性肾炎(肾病型)有一定疗效。

To explore the specific clinical manifestations of endocapillary proliferative glomerulonephritis (ECPGN) and application of renal biopsy in acute glomerulonephritis, clinical and pathological data were collected in 30 ECPGN patients by retrospective statistical analysis. The results showed that the clinical diagnosis were as nephrotic syndrome (NS) in 8 cases, as acute renal failure (ARF) in 8 cases, as IgA -nephrotic syndrome in 6 cases, as acute nephritis in 6 cases, and as hidden nephritis in 2 cases. The pathology showed that there was a significant pathological change with crescents formation in NS and ARF. IgG and C3 immune fluorescent deposits like 'garland' were observed in 5 cases of NS. It is suggested that there were different clinical manifestations, renal biopsy may be useful for the diagnosis of ECPGN, and prednisolone can be effect for the treatment of NS - acute nephritis.