小儿紫癜性肾炎的临床病理及远期预后分析

Clinical Pathology and Long Term Prognosis of HenochSchonlein Nephritis in Children

摘要:

目的：分析小儿紫癜性肾炎的临床、病理与远期预后的关系。方法：比较32例紫癜性肾炎的临床病理变化，随访其中19例，随访期限8～14年，了解临床及病理对远期预后的影响。结果：小儿紫癜性肾炎的临床分型中以急性肾炎综合征型多见，占50%，肾病综合征型次之占40%；病理变化以Ⅱ～Ⅲ级多见。急性肾炎综合征型与肾病综合征型随访比较，痊愈率分别为55.6%(5/9例)和28.6%(2/7例)；病理分级Ⅰ～Ⅲ级的痊愈率为43.8%(7/16例)，恶化率12.5%(2/16例)，Ⅳ～Ⅴ级中66.7%(2/3例)恶化或死亡。结论：急性肾炎综合征型远期预后较肾病综合征型好，远期预后与临床分型及病理分级密切相关。

Abstract:

OBJECTIVE: To analyze the relationship between the clinical and pathological effects and longterm prognosis in children with Henoch Schonlein nephritis. METHODS: Changes of clinical pathology were studied in 32 children with Henoch Schonlein nephritis and 19 cases of them were followed over an 8 to 14 year period. RESULTS: Acute nephritis ranked first (50%) and the nephritic syndrome ranked second (40%) in the clinical classification of Henoch Schonlein nephritis; the majority had pathological changes of Grade Ⅱ～Ⅲ. The rate of recovery of acute nephritis and the nephritic syndrome was 55.6% and 28.6%, respectively. The rate of recovery and deterioration of Grade Ⅰ～Ⅲ pathological changes was 43.8% and 12.5%, respectively. Of the patients with Grade Ⅳ～Ⅴ pathological changes, 66.7% deteriorated or died. CONCLUSIONS: The prognosis of acute nephritis was better than that of the nephritic syndrome, and longterm prognosis is closely associated with the clinical classification and pathology