| 摘要: |
| 目的:探讨儿童肾病综合征(NS)型免疫球蛋白A 肾病(IgAN)的临床特征和预后。方法:回顾性纳入经肾活检明确诊断
为儿童IgAN 的186 例患儿,其中53 例(28. 49%)表现为NS 的患儿纳入NS-IgAN 组,其余为非NS-IgAN 组。通过倾向评分匹配
法,选择55 例表现为肾病范围蛋白尿、血清白蛋白正常的儿童为正常血白蛋白IgAN( NR-IgAN) 组。比较NS-IgAN 组和非
NS-IgAN 组,NS-IgAN 组和NR-IgAN 组临床及病理表现。结果:NS-IgAN 组收缩压(SBP)、血小板(PLT)和乳酸脱氢酶(LDH)水
平均高于非NS-IgAN 组,白蛋白水平低于非NS-IgAN 组(P<0. 05)。NS-IgAN 组牛津分型M1、E1、T1、T2 和C1 百分比均高于非
NS-IgAN 组(P<0. 05)。NS-IgAN 组PLT、D-D 二聚体、纤维蛋白原( FIB) 和LDH 水平均高于NR-IgAN 组,白蛋白、血清IgG 和
CD4 T 细胞水平均低于NR-IgAN 组( P <0. 05)。NS-IgAN 组牛津分型E1、T1 和C1 百分比均高于NR-IgAN 组( P <0. 05)。
NS-IgAN 组肾脏存活率低于非NS-IgAN 组(χ2 = 4. 854,P = 0. 028);低白蛋白组肾脏存活率低于正常白蛋白组( χ2 = 3. 893,P =
0. 048)。结论:NS 在儿童IgAN 并不罕见。NS-IgAN 患儿临床和病理表现更重,预后更差。血肌酐、低白蛋白、T1 和C1 病理变
化是儿童IgAN 进展为终末期肾脏病的独立危险因素。 |
| 关键词: 免疫球蛋白A 肾病 肾病综合征 低蛋白血症 儿童 预后 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.07.008 |
|
| 基金项目:徐州市儿童医院科研项目,编号22040440。 |
|
| Clinical and Pathological Characteristics and Prognosis Analysis of Children with Nephrotic Syndrome TypeImmunoglobulin A Nephropathy |
| Zhou Suqin, Zhu Bingbing |
| ((The Affiliated Xuzhou Children’s Hospital of Xuzhou Medical University, Jiangsu Xuzhou 221000, China)) |
| Abstract: |
| Objective: To probe into the clinical characteristics and prognosis of children with nephrotic syndrome ( NS) type
immunoglobulin A nephropathy ( IgAN). Methods: A total of 186 children diagnosed with IgAN through renal biopsy were
retrospectively included. Among them, 53 cases (28. 49%) presented as NS and were included in the NS-IgAN group, while the
remaining cases were extracted as the non-NS-IgAN group. By means of propensity score matching, 55 children with proteinuria within
the nephrotic range and normal serum albumin were extracted as the normal albumin IgAN (NR-IgAN) group. The clinical and
pathological characteristics were compared between NS-IgAN group and non-NS-IgAN group, NS-IgAN group and NR-IgAN group.
Results: The NS-IgAN group showed significantly higher systolic blood pressure (SBP), platelet (PLT), and lactate dehydrogenase
(LDH) levels, and lower albumin levels than non-NS-IgAN group (P<0. 05). The proportions of Oxford classification lesions M1, E1,
T1, T2, and C1 were significantly higher in the NS-IgAN group than those in the non-NS-IgAN group (P<0. 05). Compared with the
NR-IgAN group, the NS-IgAN group had significantly higher PLT, D-D dimer, fibrinogen (FIB), and LDH levels, and lower albumin,
IgG, and CD4+ T cell levels (P<0. 05). The proportions of Oxford classification lesions E1, T1, and C1 were significantly higher in the
NS-IgAN group than those in NR-IgAN group (P<0.05). The renal survival rate in the NS-IgAN group was lower than that in non-NS-IgAN
group (χ2 =4.854, P=0.028), the renal survival rate in the low albumin group was lower than that in the normal albumin group (χ2 =3.893,
P =0. 048). Conclusion: NS is not uncommon in children with IgAN. The clinical and pathological manifestations of children with
NS-IgAN are more severe and the prognosis is worse. Pathological changes in serum creatinine, low albumin, T1 and C1 are
independent risk factors for the progression of IgAN in children to end-stage kidney disease. |
| Key words: immunoglobulin A nephropathy nephrotic syndrome hypoproteinemia children prognosis |
