目的:研究病理分级为Ⅲ级的紫癜性肾炎患儿的临床病理特点及预后。方法:回顾性分析了2005年1月~2013年6月于温州医科大学附属育英儿童医院儿童肾内科住院,经肾活检病理诊断为紫癜性肾炎Ⅲ级患儿资料,比较患儿的临床表现和病理特点,分析了解临床与病理特点之间的关系。结果:(1)HSPN-Ⅲa组29例,HSPN-Ⅲb组23例。HSPN-Ⅲb组患儿的体重校正尿蛋白多于HSPN-Ⅲa组。(2)HSPN-Ⅲb组较HSPN-Ⅲa组肾小管萎缩及间质纤维化、重度系膜增生更为多见,系膜增生程度更为严重。(3)两组患儿在治疗及疾病转归上差异无统计学意义。结论:Ⅲb级HSPN蛋白尿程度及肾小管萎缩、系膜增生更为严重,早期积极予以激素联合免疫抑制剂干预可获得良好的短期疗效。
Objective: To investigate the clinicopathogical characteristics and outcome of Henoch- Schonlein purpura nephritis grade Ⅲ in children. Methods: Retrospectively analyzed the clinicopathogy and follow- up data of children whom were biopsy- proven HSPN grade Ⅲ in our hospital from January 2005 to June 2013,and then compared the HSPN grade Ⅲa and Ⅲb. Results:( 1) In contrast to the 29 cases of HSPN- Ⅲa group,the 23 cases of HSPN- Ⅲb group showed more urine protein corrected by body weight.( 2) Compared with the HSPN- Ⅲa group,the HSPN- Ⅲb group had more renal tubulointerstitial lesions and severe mesangial proliferative glomerulonephritis.( 3) The two group showed no statistically significant differences in treatment and outcome.Conclusion: HSPN grade Ⅲb showed severity of proteinuria,renal tubulointerstitial lesions and mesangial proliferative. Immunosuppressant treatment in the early stage of disease is effective for a short term outcome.