儿童孤立性血尿型紫癜性肾炎135例临床分析

Analysis of the clinical features of isolated hematuria Henoch-Schonlein purpura nephritis of children in 135 cases

目的探讨儿童孤立性血尿型紫癜性肾炎(HSPN)的临床特征。方法回顾性分析2003年11月至2014年12月河南中医药大学第一附属医院儿科收治的孤立性血尿型HSPN患儿的临床资料。结果 135例患儿纳入本研究,其中男80例,女55例,男女比例为1.45∶1;年龄(9.24±5.32)岁;单纯皮肤紫癜31例,紫癜伴腹痛33例,紫癜伴关节痛28例,紫癜伴腹痛、关节痛43例;血尿病程(8.62±7.28)个月;7例患儿行肾组织活检。135例患儿中,给予普通治疗31例,免疫抑制剂治疗104例;普通治疗患儿治疗后痊愈19例,孤立性血尿8例,轻度蛋白尿3例,中度蛋白尿1例;免疫抑制剂治疗患儿治疗后痊愈72例,孤立性血尿23例,轻度蛋白尿7例,中度蛋白尿1例,重度蛋白尿1例;普通治疗与免疫抑制剂治疗患儿预后比较差异无统计学意义(z=0.65,P=0.516)。结论孤立血尿型HSPN患儿整体预后良好,但仍有少数患者可发展为中、重度蛋白尿。

Objective To analyze the clinical features of isolated hematuria Henoch-Schonlein purpura nephritis（HSPN）. Methods The clinical data of children with isolated hematuria HSPN diagnosed in the First Affiliated Hospital of Henan University of Chinese Medicine from November 2003 to December 2014 was analyzed retrospectively. Results One hundred and thirty-five isolated hematuria HSPN patients were rolled in the study. Eighty cases were male and fifty-five cases were female. Male to female was 1. 45∶1,average age was（9. 24 ± 5. 32） years old. Thirty one cases had pure skin purpura,thirty three cases had purpura accompany with abdominal pain,twenty eight cases had purpura accompany with arthralgia,forty three purpura accompany with abdominal pain and arthralgia. The pathogenesis was（8. 62 ± 7. 28） months. Seven cases were given nephridial tissue biopsy. In the 135 cases,there were 31 cases accepted general therapy,and 104 cases accepted the therapy of immunodepressant. In the patients with general therapy,there were 19 cases with recovery,8 cases with isolated hematuria,3 cases with mild proteinuria,1 case with moderate proteinuria. In the patients with therapy of immunodepressant,there were72 cases with recovery,23 cases with isolated hematuria,7 cases with mild proteinuria,one case with moderate proteinuria,one case severe proteinuria. There was no significant difference in the prognosis between the general therapy patients and immunodepressant therapy patients（z = 0. 65,P = 0. 516）. Conclusion The prognosis of the HSPN in children accompany with isolated haematuria is favourable,but a few patients may progress to moderate and severe proteinuria.