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纸质出版:2011
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谢丹凤,李秋.509例儿童肾活检病理及临床分析[J].陆军军医大学学报(原第三军医大学学报),2011,33(16):1736-1739.
Xie Danfeng,Li Qiu.Pathological characteristics and clinical manifestations in 509 children with renal diseases from a single unit[J].J Amry Med Univ (J Third Mil Med Univ),2011,33(16):1736-1739.
目的 探讨儿童肾小球疾病病理特点及其与临床表现的关系。 方法 回顾性分析2007年1月至2010年5月在重庆医科大学附属儿童医院进行肾活检的509例患儿病理及临床资料,比较原发性肾小球疾病和继发性肾小球疾病的病理和临床特征。 结果 ①509例肾活检患儿中,原发性肾小球疾病315例,继发性肾小球疾病184例,遗传性肾小球疾病和肾血管疾病分别为6例、2例,肾小管间质性肾炎2例。②与原发性肾小球疾病组比较,继发性肾小球疾病组平均受检年龄大于原发性肾小球疾病组[(10.54±2.72)岁 vs (8.62±3.28)岁],受检时平均病程较原发性肾小球疾病组短(30.00 d vs 60.00 d)。③原发性肾小球疾病组最常见的临床表现和病理类型分别为肾病综合征、系膜增生性肾小球肾炎(MsPGN),继发性肾小球疾病组中分别为过敏性紫癜性肾炎和MsPGN。④近年来本院受检儿童肾小球疾病构成比发生变化。原发性肾小球疾病仍为最常见的肾小球疾病,最常见的病理类型是MsPGN和IgA肾病。孤立性血尿及狼疮性肾炎比例增加。 结论 肾脏病理检查技术的开展促进了肾小球疾病诊疗水平的提高,同时该技术可能也直接影响肾小球疾病住院构成比的变化。
Objective To explore the relationship between the pathological characteristics and clinical manifestations of renal glomerular diseases in children. Methods Retrospective analysis was performed using the pathological and clinical data of 509 children with renal diseases to compare primary glomerular disease and secondary glomerular disease in terms of pathological characteristics and clinical manifestations. These children received renal biopsy in the Children’s Hospital of Chongqing Medical University from January 2007 to May 2010. Results (1) Among these patients
315 (61.9%) cases of primary glomerular disease
184 (36.1%) cases of secondary glomerular disease
6 (1.2%) cases of hereditary glomerular disease
2 (0.4%) cases of renal vascular disease
and 2 (0.4%) cases of renal tubulointerstitial disease were found. (2) The mean age when the renal biopsy was performed in the group of secondary glomerular disease was greater than that in the group of primary glomerular disease [(10.54±2.72) years vs. (8.62±3.28) years]. The mean course of disease from onset to renal biopsy in the group of secondary glomerular disease was shorter than that in the group of primary glomerular disease (30.00 days vs. 60.00 days). (3) The most common clinical diagnosis and pathological category in the group of primary glomerular disease were nephrotic syndrome and mesangial proliferative glomerulonephritis (MsPGN)
respectively
and those in the group of secondary glomerular disease were Henoch-Schonlein purpura nephritis and MsPGN
respectively. (4) In recent years
the spectrum of children’s renal glomerular diseases in our center changed. Primary glomerular disease was still the most common glomerular disease
and MsPGN and IgA nephropathy were the most common pathological categories. The proportions of isolated hematuria and lupus nephritis increased. Conclusion Examination of renal tissue is necessary to document the histological type and magnitude of renal injury
which are necessary in planning management of the disease. Carrying out this technique may lead to the clinico-pathological spectrum variation of children’s renal glomerular diseases.
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