353例小儿肾小球疾病的病理及临床分布特点

目的 了解小儿肾小球疾病病理与临床分布特点。方法 收集353例肾活检患儿资料进行回顾性分析。结果 353例患儿中诊断为紫癜性肾炎117例(33.1%),孤立性血尿94例(26.6%),原发性肾病综合征87例(24.6%),急性肾炎综合征23例(6.5%),其次还有乙肝相关性肾炎、狼疮性肾炎、孤立性蛋白尿、慢性肾炎等。肾小球疾病中以原发性肾小球疾病最为常见(206例,占58.4%),病理改变主要为:系膜增生性肾小球肾炎(MsPGN)66例,占32.0%; IgA肾病(IgA N)54例,占26.2%;轻微病变37例,占18.0%;其他还包括微小病变(MCD)、膜增生性肾小球肾炎(MPGN)、膜性肾病(MN)、毛细血管增生性肾小球肾炎等。继发性肾小球疾病以紫癜性肾炎最常见。结论 肾小球疾病以原发性肾小球疾病为主,临床诊断以孤立性血尿最常见,继发性肾炎以紫癜性肾炎最常见。

Pathologic and clinical characteristics of infantile glomerular diseases in 353 cases

Objective To explore the pathological and clinical features of glomerular diseases in children. Methods The pathological data of 353 children with biopsy-proven glomerular diseases were retrospectively analyzed. Results 353 cases of children were separately diagnosed with Henoch-Schonlein purpura nephritis (117 cases, accounting for 33.1%), isolated hematuria (94 cases, 26.6%), primary nephrotic syndrome (87 cases, 24.6%), acute nephritis syndrome (23 cases, 6.5%), followed by hepatitis B-related nephritis, lupus nephritis, isolated proteinuria, chronic nephritis, etc. The primary glomerular disease was the most common glomerular diseases (206 cases, 58.4%), its pathological changes mainly manifested as mesangial proliferative glomerulonephritis (75 cases, 34.9%), IgA nephropathy (54 cases, 25.1%) and glomerular minor lesion (37 cases, 17.2%), and the others included minimal change disease, membrane proliferative glomerulonephritis, membranous nephropathy, capillaries proliferative glomerulonephritis, etc. The most common secondary glomerular disease was Henoch-Schonlein purpura nephritis. Conclusion Primary glomerular diseases are most common in infantile glomerular diseases, with main clinical diagnosis of isolated hematuria, and the most common secondary glomerulonephritis is Henoch-Schonlein purpura nephritis.