免疫球蛋白A肾病与紫癜性肾炎患儿临床病理比较

目的对比研究IgA肾病(IgAN)和紫癜性肾炎HSPN患儿临床表现、辅助检查结果及病理改变的异同,探讨两者的关系。方法比较33例IgAN和69例HSPN患儿的临床表现、尿常规、血常规、24h尿蛋白定量、血浆免疫球蛋白(Ig)、C3和C4等指标及肾病理活检结果。结果IgAN组男性发病率明显高于女性,发病前常有呼吸道感染病史;临床上以血尿为主,缺乏皮疹、腹痛、消化道出血症状,血红蛋白低于HSPN组。而IgAN和HSPN在水肿、高血压、蛋白尿程度、血浆清蛋白水平及血IgG、IgA、IgM、IgE、C3、C4水平及肾病理改变程度及特征方面无显著差异。结论IgAN和HSPN在临床、免疫学指标、病理改变方面极其相似,是否为同一疾病的不同阶段,有待进一步探讨。

Comparison of Clinical Pathology in Children with Immunoglobulin A Nephropathy and Henoch- Schonlein Purpura Nephritis

Objective To explore the relationship of immunoglobulin A(IgA) nephropathy (IgAN) and Henoch - Schonlein purpura nephritis(HSPN) in children by making comparison in the aspects of clinical symptoms, laboratory tests and renal pathology. Methods Process the data of 69 cases of HSPN and 33 cases of IgAN respectively in clinical symptoms' frequency, indices of urinalysis and blood cell count, protein quantity in urine of 24 hours, serum level of immunoglobulins, C3 and C4, as well as renal pathologic results. Results In IgAN group, the incidence of male was higher than that of female, respiratory tract infections usually occur as prodrome. Macroscopic hematuria was the most prominent clinical feature, while rash, joint pain, abdominal symptoms seldom happened. Level of hemoglobin in IgAN group was decreased significantly. There were no significant differences in edema, hypertension, proteinuria degree, level of plasm albumin, level of serum IgA, IgG, IgM, IgE, C3 and C4, as well as the features of renal pathologic changes between IgAN and HSPN.Conclusions IgAN and HSPN have similar features in clinical symptoms,level of immunoglobulins and complements and renal pathology. But it is still under discussion whether they are different stages of the same disease.