| 摘要: |
| 目的:探讨伴肉眼血尿的儿童原发性IgA 肾病的临床及病理特征。方法:回顾性分析2014年1月至2017年5月在我院肾活检确诊的106例原发性IgA肾病患儿的资料,比较肉眼血尿组及无肉眼血尿组间的临床及病理特征。结果:肉眼血尿组与无肉眼血尿组比较,年龄、性别、体质量指数、血压、血尿酸水平、血红蛋白水平、贫血发生率、蛋白尿水平、血清白蛋白、血清IgM、补体C3、补体C4 水平差异无统计学意义(P>0.05)。肉眼血尿组患儿更容易伴随前驱感染且病程更短,其eGFR明显低于无肉眼血尿组,分别为(153.81±72.30)mL/ (min·1.73 m2 )及(182.92±54.65)mL/ (min·1.73 m2 ),而血IgA、IgG 明显高于无肉眼血尿组,分别为(2.69±0.93)g/L、(9.26±3.41)g/L及(1.93±0.62)g/L、(6.67±2.56)g/L。肉眼血尿组患儿出现新月体的可能性(56.8%)要大于无肉眼血尿组(25.8%)。结论:伴肉眼血尿的儿童原发性IgA 肾病患儿临床表现较重,容易出现肾功能下降、大量蛋白尿等表现,其肾脏活动性病变程度明显重于无肉眼血尿的患儿且更容易出现新月体,而在慢性化病变方面比较两组差异无统计学意义。 |
| 关键词: IgA肾病 肉眼血尿 临床特征 病理特征 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2018.10.004 |
|
| 基金项目:湖南省科技创新平台与人才计划,编号2016SK4004 |
|
| Clinical and Pathological Features of Primary IgA Nephropathy in Children with Gross Hematuria |
| Xun Mai, Li Zhihui, Duan Cuirong, Zhang Yi, Wu Tianhui, Ding Yunfeng, Kang Zhijuan |
| (Hunan Children's Hospital, Hunan Changsha 410007, China) |
| Abstract: |
| Objective: To probe into the clinical and pathological features of primary IgA nephropathy in children with gross hematuria.
Methods: Retrospective analysis was conducted on 106 patients with primary IgA nephropathy admitted into our hospital from Jan. 2014
to May 2017. The clinical and pathological features of gross hematuria group and no gross hematuria group were compared. Results:
There was no statistical difference in age, gender, body mass index, blood pressure, blood uric acid level, hemoglobin level, anemia
incidence, proteinuria level, serum albumin, serum IgM, complement C3 and complement C4 levels in the gross hematuria group and no
gross hematuria group (P>0.05). Children with gross hematuria were more likely to be associated with pre-infection and had a shorter
course of disease. The eGFR was significantly lower in gross hematuria group [(153.81±72.30) mL/ (min·1.73 m2 )] than that in no
gross hematuria group [(182.92±54.65) mL/ (min·1.73 m2 )]; yet the blood IgA and IgG of gross hematuria group [(2.69±0.93)
g/L, (9.26±3.41)g/L] were significantly higher than those of no gross hematuria group [(1.93±0.62)g/ L, (6.67±2.56)g/L].
The crescents in gross hematuria group (56.8%) was greater than that in no gross hematuria group (25. 8%). Conclusion: Children
with primary IgA nephropathy with gross hematuria have a severe clinical manifestation, which is prone to renal function decline,
massive proteinuria, etc. The degree of renal activity is significantly higher than that of children without gross hematuria and is more prone to crescentic, yet there is no significant difference between two groups in the comparison of chronic lesions. |
| Key words: IgA nephropathy grossc hematuria clinical features pathological features |
