353例小儿肾小球疾病的病理及临床分布特点

Pathologic and clinical characteristics of infantile glomerular diseases in 353 cases

目的了解小儿肾小球疾病病理与临床分布特点。方法收集353例肾活检患儿资料进行回顾性分析。结果 353例患儿中诊断为紫癜性肾炎117例(33.1%),孤立性血尿94例(26.6%),原发性肾病综合征87例(24.6%),急性肾炎综合征23例(6.5%),其次还有乙肝相关性肾炎、狼疮性肾炎、孤立性蛋白尿、慢性肾炎等。肾小球疾病中以原发性肾小球疾病最为常见(206例,占58.4%),病理改变主要为:系膜增生性肾小球肾炎(Ms PGN)66例,占32.0%;Ig A肾病(Ig A N)54例,占26.2%;轻微病变37例,占18.0%;其他还包括微小病变(MCD)、膜增生性肾小球肾炎(MPGN)、膜性肾病(MN)、毛细血管增生性肾小球肾炎等。继发性肾小球疾病以紫癜性肾炎最常见。结论肾小球疾病以原发性肾小球疾病为主,临床诊断以孤立性血尿最常见,继发性肾炎以紫癜性肾炎最常见。

Objective To explore the pathological and clinical features of glomerular diseases in children. Methods The pathological data of 353 children with biopsy- proven glomerular diseases were retrospectively analyzed. Results 353 cases of children were separately diagnosed with Henoch-Schonlein purpura nephritis( 117 cases,accounting for 33. 1%),isolated hematuria( 94 cases,26. 6%),primary nephrotic syndrome( 87 cases,24. 6%),acute nephritis syndrome( 23 cases,6. 5%),followed by hepatitis B-related nephritis,lupus nephritis,isolated proteinuria,chronic nephritis,etc. The primary glomerular disease was the most common glomerular diseases( 206 cases,58. 4%),its pathological changes mainly manifested as mesangial proliferative glomerulonephritis( 75 cases,34. 9%),Ig A nephropathy( 54 cases,25. 1%) and glomerular minor lesion( 37 cases,17. 2%),and the others included minimal change disease,membrane proliferative glomerulonephritis,membranous nephropathy,capillaries proliferative glomerulonephritis,etc. The most common secondary glomerular disease was Henoch-Schonlein purpura nephritis. Conclusion Primary glomerular diseases are most common in infantile glomerular diseases,with main clinical diagnosis of isolated hematuria,and the most common secondary glomerulonephritis is Henoch- Schonlein purpura nephritis.