成人与儿童紫癜性肾炎的临床病理特点及预后分析

Clinical and pathological features of adults and children nephritis and prognosis

目的：研究成人与儿童紫癜性肾炎的临床病理特点及其预后情况。方法选择2011年7月至2014年7月80例HSPN患者的临床资料，全部患者采用肾活检进行检查，并给予临床分型与分级，收集并总结两组患者发病诱因。给予对症治疗，对全部患者进行随访，观察两组患者的预后。结果成人疾病有明显诱发因素的占45．0％，儿童占15．0％，成人患者肉眼血尿患者明显高于儿童（ P＜0．05）；成人高血压明显高于儿童患者（ P＜0．05）；成人肾功能不全明显高于儿童（P＜0．05）；儿童腹痛明显高于成人（P＜0．05）；儿童浮肿显高于成人（P＜0．05）；儿童关节痛明显高于成人（P＜0．05）。从临床分型与病理分级情况，儿童组患者Ⅱ级较多，Ⅴ～Ⅵ级相对较少，而成人患者Ⅴ～Ⅵ级占比较高；儿童组患者经治疗后，有效率为97．5％；成人患者有效率为90．0％，儿童高于成人，但有效性比较，差异未见统计学意义（P＞0．05）。结论儿童HSPN患者有明显诱因的高于成人患者，从临床分型与病理分级来看，HSPN患者中，儿童患者病情相对成人要轻，因此，儿童HSPN患者预后要好于成人。

Objective To investigate the clinicopathological characteristics of adults and children Henoch-schon-lein purpura nephritis（HSPN） and prognosis.Methods From July 2011 to July 2014, the clinical data of 80 cases of HSPN were chosen, all patients had biopsy-rays, and clinical classification and grading was given, the predisposing factors were collected and summarized.＆amp;nbsp;The patients were given symptomatic treatment, all patients were followed up, the prognosis of the two groups were ob-served.Results Adult diseases with significant predisposing factors accounted for 45.0%, while children with significant predisposing factors accounted for 15.0%, the incidence of gross hematuria was significantly higher in adult patients than that in children （P〈0.05）;the incidence of hypertension was significantly higher in adult patients than that in children （ P〈0.05 ）; the incidence of kidney dysfunction was significantly higher in adult patients than that in children （ P 〈0.05）;the incidence of abdominal pain was significantly higher in children than that in adult patients（P〈0.05）;the in-cidence of edema was significantly higher in children than that in adult patients（P〈0.05）;the incidence of joint pain was significantly higher in children than that in adult patients（P〈0.05）.From the clinical classification and pathological grad-ing situation, children with grade Ⅱwere more, children with gradeⅤ~Ⅵrelatively less, while adult patients with gradeⅤ-Ⅵwere more;the efficiency was 97.5%in children after treatment;the efficiency was 90.0%in adult patients after treatment, but there was no significant difference（ P＆gt;0.05 ） .Conclusions Children with HSPN have significant incen-tives than adult patients, from clinical classification and pathological grading, pediatric patients were relative light, there-fore, the prognosis of children with HSPN is better than that of adults.