【摘要】 目的:探讨过敏性紫癜(HSP)早期肾脏损害临床病理表现与免疫学指标的关系。方法:对365例确诊为过敏性紫癜患儿的临床资料进行回顾性分析。按发病时间<7d、8~14d、15~30d、31~60d及>60d进行临床分组(A、B、C、D、E组),并进行尿微量蛋白、尿常规、24小时尿蛋白定量、12小时尿液addis计数、免疫学指标的检查。365例过敏性紫癜患儿发病前有明确感染诱因的82.47%,其中呼吸道感染占70.76%。结果:尿检异常342例(93.69%),其中A组155例(42.47%),尿检异常133例(88.6%);B组,以尿微量蛋白异常、单纯蛋白尿、血尿为主,尿检异常94例(94.0%);C、D、E组尿检异常率均达100%,临床以蛋白尿+血尿为主,病程和肾脏损害程度之间存在一定相关性(P<0.005)。急性期免疫学指标IgA、IgG、IgM、IgE、C3均高于正常同龄儿童水平的2SD以上,以IgA、C3为主,并与病程的长短无关。结论:过敏性紫癜早期即存在肾脏损害,病程以超过14d者肾脏损害为重;血清IgA、C3在不同病程均较同龄儿有所升高,临床上可作为指导HSPN(紫癜性肾炎)治疗的疗效观察及减药、停药的依据。更多还原

【Abstract】 Objective: To discuss the relation between clinic appearance of early damage in kidneys of HSP and the index of immunology. Methods: Three hundred and sixty-five HSP children were reviewd and analyzed. According to the pathogenic time 7 d, 14 d, 30 d, 60 d and over 60 d they were divided into five groups, and to test the urine minium albumen, urine routine, 24 h volune of urine albumin, 12 h urine addis count and index of immunology. Result: 82.47% of disease children had definite infectious before pathogenic period, 70.76% of them were respiratory tract infection; there were 342 cases abnormal in urine test (93.69%), 155 cases were abnormal (42.47%) in the course of disease <7 d, there were 133 cases abnormal in urine test (88.6%); the abnormal urine minium albumen and hematuria were primary in the course of disease <14 d; 100% of urine test were abnormal in the course of disease >14 d, albumen urine+ hematuria were primary in clinic,there were pertinence between the course of disease and kidneys damage to certain extent (P<0.005). The index of immunology in acute stage IgA, IgG, IgM, IgE, C-3 were 2 sd higher than the normal coeval, and IgA, C-3 were primary,and were irrelevant with the course of disease. Conclusion: HSP forepart damage existed in kidneys;the damage in kidneys is primary over 14d of the course of disease; the blood serum, IgA, C-3 were higher than coeval to different extent, and there weren′t statistics meaning, but it was the reference of observing clinical effect and reducing or ceasing medicament.更多还原