【摘要】 目的探讨儿童紫癜性肾炎(HSPN)临床、病理、治疗与预后的特点。方法对2004-2007年收治的133例HSPN患儿进行随访,其中成功随访71例,对其临床表现、病理检查、治疗方案以及预后等资料进行统计学分析。结果临床分型以血尿蛋白尿最为常见,伴有消化道症状的患儿出现明显蛋白尿的概率较不伴消化道症状的患儿明显增加,差异有统计学意义(P<0.05)。44例患儿行肾组织活检,病理分级以Ⅱ、Ⅲ级最多见,占90.9%。免疫荧光显示所有病例均有IgA阳性,补体C3阳性者31例(70.5%)。依据病理分级和临床表现,给予不同的治疗方案。3例患儿预后为B级,余67例均为A级,尿检恢复正常时间为1个月～3年,与无明显蛋白尿的HSPN患儿相比较,有明显蛋白尿者尿检恢复时间显著延长,差异具有统计学意义(P=0.02)。结论儿童HSPN临床表现、病理改变各不相同,治疗应注重个体化,可按病理分级和临床表现制定不同的方案。积极治疗后多数预后良好,病初伴有明显蛋白尿的患儿尿检恢复正常的时间较长。更多还原

【Abstract】 Obstract: Objectives To explore the clinical,pathological,therapeutic and prognostic features of Henoch-Schnlein purpura nephritis(HSPN)in children.Methods A total of 133 children with HSPN was admitted and treated from 2004 to 2007.Among them 71 cases had been followed up.The clinical manifestations,pathological examination,treatment protocol and prognosis were analyzed.Results The most common clinical type was hematuria and proteinuria.The percentage of obvious proteinuria in cases with gastrointestinal sympotoms was significantly higher than that cases without gastrointestinal sympotoms(P < 0.05).Forty-four cases were conducted renal biopsy.The majority pathological grades were Grade Ⅱ and Ⅲ,90.9% the immunofluorescence test showed that all cases with IgA positive,31 cases(70.5%)with complment C3 positive.According to the pathological grade and clinical sympotoms,the children were given different treatment options.Three cases were grade B and the other 67 cases were grade A.The urine test would be normal within one month to three years.The recovery period of the HSPN children with obvious proteinuria was longer than that of the children without significant proteinuria.Conclusions Because the diversity of clinical features and pathological grade in children with HSPN,the treatment should be individualized.The treatment protocal should be developed according to the pathological grade and clinical features.Most of the patients have a good prognosis.The recovery time of the children with obvious proteinuria will be longer.更多还原