紫癜性肾炎的肾脏病理表现

目的：探求紫癜性肾炎肾脏病理在不同年龄与不同性别之间的差异。方法：从1491例肾活检患者中收集紫癜性肾炎病例,要求取材标本的肾小球数目≥10个。分别按年龄分为儿童组（〈16岁）和成人组（≥16岁）,按性别分为男性组和女性组,对比分析病理特点。结果：①1491例肾活检患者中共入选紫癜性肾炎57例。②57例紫癜性肾炎患者分为男性组（33例）和女性组（24例）,男性组的免疫球蛋白A（≥3＋）和纤维蛋白沉积的发生率分别为90%和96.7%,较女性组的66.7%和79.2%高（P〈0.05）;其他的病理学指标两组无统计学差异。③57例紫癜性肾炎患者分为儿童组（12例）和成人组（45例）,结果显示：肾小球病变中成人组的纤维素样坏死、微血栓和新月体的发生率分别为8.9%、28.9%和48.9%,高于儿童组的0%、8.3%和16.7%（P〈0.05）;肾小管-间质病变中成人组的肾小管萎缩和间质纤维化发生率分别为26.7%和17.8%,较儿童组的0%和0%高,P〈0.05;免疫荧光法检查中免疫球蛋白M（≥2＋）沉积在儿童组中的发生率83.3%,高于成人组的47.6%（P〈0.05）;补体3沉积在成人组中的发生率76.2%,较儿童组的41.7%高（P〈0.05）;其他的病理学指标两组无统计学差异。结论：成人紫癜性肾炎的肾脏病理重于儿童;男性紫癜性肾炎的肾脏病理重于女性。

Pathological Features of Henoch-Schonlein Purpura Nephritis

Objective：To evaluate the difference of pathological features between adult and childhood patients, male and female patients with Henoch-Sch6nlein purpura nephritis （HSPN）. Methods： Collecting HSPN patients among 1491 cases of renal bi opsy from 2002 to 2006. Entry criteria： （1） Diagnostic criteria of HSPN. （2）10 or more glomerulus in renal specimen. The difference of pathological features of HSPN between adult and childhood patients, male and female patients were analized. Resuits： （1）Among 1491 patients with renal biopsy, 57 patients with HSPN were enrolled. （2）57 HSPN patients enrolled were divided into male group （33 cases） and female group （24 cases）. The comparison of the two groups was as follow： the frequency of patients with deposits of immuneglobulin A（≥3 ＋ ） was higher in the male group than in the female group （90% vs 66.7%, P〈0.05）, fibrin （96.7 % vs 79.2%, P〈0. 05 ） ; there was no significant difference of other pathological features between the two groups. （3）57 HSPN patients enrolled were divided into children group （12 cases） and adults group （45 cases）. The comparison of the two groups was as follow： the frequency of patients with cellulose necrosis of glomerulus was higher in the adults group than in the children group （8. 9% vs 0%, P〈0. 05）, micro-thrombosis （28.9% vs. 8. 3%, P〈0. 05）, crescent （48.9% vs. 16.7%, P〈0.05）; the frequency of patients with tubular atrophy was higher in the adults group than in the children group （26.7% vs. 0%, P〈0.05）, fibrosis （17.8% vs 0%, P〈0. 05） ; the frequency of patients with deposits of immuneglobulin M（≥2 ＋ ） was higher in the children group than in the adults group （83.3% vs. 47.6%, P〈0.05） ; the frequency of patients with deposits of complement 3 was higher in the adults group than in the children group （76.2% vs. 41.7%, P〈0.05）; there was no significant difference of other pathological features between the two groups. Conclusion; Ren