小儿肾小球疾病62例甲皱微循环观察

Observation on Microcirculation in Nail Fold of Patients with Glomerular Disease in 62 Children

目的 :探讨肾小球疾病患儿的甲皱微循环变化。方法 :应用甲皱显微镜对 6 2例肾小球疾病患儿的甲皱微循环变化进行观察 ,并与 70例正常儿童比较。结果 :①肾小球疾病患儿甲皱微循环的各项积分值、总积分值与正常儿童比较 ,有非常显著差异 (P <0 .0 0 1) ;②急性肾小球肾炎与肾病综合征患儿甲皱微循环各项积分值无明显差异(P >0 .0 5 ) ,而总积分值有明显差异 (P <0 .0 5 ) ;③病情轻、重患儿甲皱微循环各项积分值、总积分值比较有非常显著差异 (P <0 .0 1) ;④治疗前后甲皱微循环各项积分值、总积分值比较 ,差异非常显著 (P <0 .0 1～ 0 .0 0 1)。结论 :肾小球疾病患儿存在不同程度的微循环障碍 ,且随病情进展 ,变化显著。肾病综合征患儿微循环障碍较急性肾小球肾炎患儿明显。应用 6 5 4- 2及活血化瘀中药治疗后 ,甲皱微循环障碍明显改善。提示开展甲皱微循环检查不仅有助于小儿肾小球疾病的判断与疾病预后的估计 ,而且可用以指导治疗。

Objective:To investigate the changes of microcirculation in nail fold of children with glomerular disease(Acute glomerulonephritis and nephrotic syndrome).Methods:Microcirculation in nail fold of 62 children with glomerular disease was measured by microscope with nail fold and were compared with that of 70 healthy children.Results:①Each individual value integral and total accumulative value integral of microcirculation in nail fold of patient with glomerular disease were significantly higher than that in control group( P <0.001);②There was no significantly differences between the two groups in each individual value( P >0.05),but the accumulative value of microcirculation in nail fold of nephrotic syndrome (NS) group significantly higher than that in the acute glomerulonephritis (AGN) group ( P <0.05);③The tudividual value and total accumulative value of microcirculation in nail fold in severe patieufs was significantly hifher than that of mild patient( P <0.01);④The undividual value and total accumulative value integral of microcirculation in nail fold in after therapy was significantly lower than that before therapy ( P <0.01～0.001).Conclusion:Different degree of disturbed microcirculation occurs in children with glomerular disease and are correlated with disease severity.Disturbed microcirculation in NS significantly higher than that in AGN.Microcirculation in nail fold of children was significantly improved by using 654-2 and traditional chinese medicine for improving circulation and resoling blood sfaris.Examination of microcirculation in nail fold is useful for diagnosis prognosis and treatment of glomerular diseares.