Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 ...Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 % children with IgA nephropathy, but only 10 % in HSPN （P〈0.05）. The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia, compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6 % of HSPN and 29 % of IgA nephropathy （all P〈0.01）. Thin basement membrane nephropathy was only found in 6. 5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, lodse and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2% of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits, moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71. 9 G of HSPN had IgG deposits in glomeruli and only 19.4% of IgA nephropathy showed glomerular IgG deposits （P〈0. 01）. No IgG deposit was observed in 81. 6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn＇t be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5% of HSPN, but only 19.4% in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16. 1% had active nephritides （P〈0.05）. It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn＇t support the one disease entity hypothesis. HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.展开更多
目的系统评价雷公藤多苷联合泼尼松在治疗小儿过敏性紫癜性肾炎(HSPN)方面的临床疗效。方法以各数据库建库至2018年1月为检索时间,通过检索万方(Wanfang)、中国知网(CNKI)、中国生物医学文献数据库(CBMdisc)、维普(VIP)等及Pubmed数据库...目的系统评价雷公藤多苷联合泼尼松在治疗小儿过敏性紫癜性肾炎(HSPN)方面的临床疗效。方法以各数据库建库至2018年1月为检索时间,通过检索万方(Wanfang)、中国知网(CNKI)、中国生物医学文献数据库(CBMdisc)、维普(VIP)等及Pubmed数据库,收集雷公藤多苷联合泼尼松治疗HSPN的随机对照试验文献,采用Rev Man 5.3软件进行Meta分析。结果纳入文献6篇,患者累计446例。结果显示,雷公藤多苷联合泼尼松可显著减短HSPN患儿的蛋白尿消退时间[WMD=-8.68,95%CI:-10.22^-7.15,P<0.00001(<0.01)]及血尿消退时间[WMD=-29.07,95%CI:-42.77^-15.36,P<0.0001(<0.01)],并显著提高总有效人数[WMD=1.21,95%CI:1.13~1.30,P<0.00001(<0.01)],其治疗效果显著优于单用泼尼松的HSPN患者。结论雷公藤多苷联合泼尼松治疗HSPN的临床疗效优于单用泼尼松。展开更多
[目的]系统评价肾炎康复片治疗紫癜性肾炎的疗效及安全性。[方法]计算机检索中国知网(CNKI)、维普(VIP)、万方(Wanfang)、中国生物医学文献服务系统(SinoMed)、PubMed、Cochrane Library、Web of Science,检索时间为建库至2023年6月20日...[目的]系统评价肾炎康复片治疗紫癜性肾炎的疗效及安全性。[方法]计算机检索中国知网(CNKI)、维普(VIP)、万方(Wanfang)、中国生物医学文献服务系统(SinoMed)、PubMed、Cochrane Library、Web of Science,检索时间为建库至2023年6月20日,搜集关于肾炎康复片治疗紫癜性肾炎的随机对照试验(RCT)。由两名研究者独立筛选文献、提取数据,采用Cochrane推荐的风险偏倚评估工具ROB2评估文献的偏倚风险,随后交叉核对。应用RevMan 5.4软件进行统计分析,对肾炎康复片治疗紫癜性肾炎的疗效及安全性进行系统评价。[结果]纳入9篇文献,样本量共853例。总体偏倚风险中,2项研究评为高偏倚风险,7项研究评为有一定偏倚风险。Meta分析结果提示,肾炎康复片能够提升治疗紫癜性肾炎患者的临床疗效[RR=1.19,95%CI(1.10,1.30),P<0.0001],降低24 h尿蛋白定量[SMD=-0.78,95%CI(-1.01,-0.56),P<0.00001],改善蛋白尿疗效[RR=2.23,95%CI(1.77,2.83),P<0.00001],降低尿红细胞计数[SMD=-0.70,95%CI(-1.04,-0.37),P<0.0001],改善血尿疗效[RR=1.66,95%CI(1.05,2.60),P=0.03]。肾炎康复片联合西医常规治疗的不良事件较少。[结论]肾炎康复片在紫癜性肾炎患者的治疗中安全有效,受纳入研究数量和质量的限制,该结论尚待更多高质量研究予以验证。展开更多
文摘Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 % children with IgA nephropathy, but only 10 % in HSPN （P〈0.05）. The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia, compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6 % of HSPN and 29 % of IgA nephropathy （all P〈0.01）. Thin basement membrane nephropathy was only found in 6. 5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, lodse and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2% of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits, moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71. 9 G of HSPN had IgG deposits in glomeruli and only 19.4% of IgA nephropathy showed glomerular IgG deposits （P〈0. 01）. No IgG deposit was observed in 81. 6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn＇t be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5% of HSPN, but only 19.4% in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16. 1% had active nephritides （P〈0.05）. It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn＇t support the one disease entity hypothesis. HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.
文摘目的系统评价雷公藤多苷联合泼尼松在治疗小儿过敏性紫癜性肾炎(HSPN)方面的临床疗效。方法以各数据库建库至2018年1月为检索时间,通过检索万方(Wanfang)、中国知网(CNKI)、中国生物医学文献数据库(CBMdisc)、维普(VIP)等及Pubmed数据库,收集雷公藤多苷联合泼尼松治疗HSPN的随机对照试验文献,采用Rev Man 5.3软件进行Meta分析。结果纳入文献6篇,患者累计446例。结果显示,雷公藤多苷联合泼尼松可显著减短HSPN患儿的蛋白尿消退时间[WMD=-8.68,95%CI:-10.22^-7.15,P<0.00001(<0.01)]及血尿消退时间[WMD=-29.07,95%CI:-42.77^-15.36,P<0.0001(<0.01)],并显著提高总有效人数[WMD=1.21,95%CI:1.13~1.30,P<0.00001(<0.01)],其治疗效果显著优于单用泼尼松的HSPN患者。结论雷公藤多苷联合泼尼松治疗HSPN的临床疗效优于单用泼尼松。
