349例儿童和成人紫癜性肾炎(血尿和蛋白尿型)临床和病理特点分析

Clinicopathological Comparison Between 349 Pediatric and Adult Patients with Henoch-Sch nlein Purpura Nephritis Presenting Hematuria and Proteinuria

目的:探讨349例儿童和成人HSPN(血尿和蛋白尿)临床和肾脏病理差异及其相关性。方法:回顾分析2017年01月—2019年12月,在河南中医药大学第一附属医院肾内科及儿科住院HSPN(血尿和蛋白尿型)患者的临床、生化及肾脏病理。结果:儿童组与成人组比较,24 h尿蛋白定量和血清胆固醇均显著降低(P<0.01),肾小球和肾小管间质主要病理级别为Ⅲa级和(+)级,成年组为Ⅲb级和(++)级,两组差异具有统计学意义(P<0.001);新月体比例低于成年组(P<0.01)。两组24 h尿蛋白定量与肾小球病理分级呈正相关(P<0.01;P<0.05),成人组血清白蛋白与肾小球病理分级呈负相关(P<0.05)。结论:成人HSPN(血尿和蛋白尿型)患者的临床和新月体比例、病理分级比儿童严重;两组24 h尿蛋白定量与肾脏病理分级呈正相关。

Objective:To investigate the clinical and renal pathological differences and correlation of HSPN(hematuria and proteinuria)between children and adults.Methods:A retrospective analysis of the clinical,biochemical and renal pathology of HSPN(hematuria and proteinuria)patients in the Department of Nephrology and Pediatrics of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2017 to December 2019.Results:Compared with the adult group,the 24-hour urine protein quantification and serum cholesterol were significantly reduced(P<0.01).The main pathological grades of the glomerulus and tubular interstitium were grade IIIa and(+),and the adult group was grade IIIb and(++)grade,the difference between the two groups was statistically significant(P<0.001);the proportion of crescents was lower than that of the adult group(P<0.01).The 24-hour urine protein quantification of the two groups was positively correlated with glomerular pathological grade(P<0.01;P<0.05),and serum albumin in the adult group was negatively correlated with glomerular pathological grade(P<0.05).Conclusion:Adult HSPN(hematuria and proteinuria)patients had more severe clinical and crescent body ratios and pathological grades than children;24-hour urine protein quantification in the two groups was positively correlated with renal pathological grades.