摘要
目的 探讨儿童孤立性血尿的肾组织病理类型与临床特点.方法 回顾性分析1995年至2008年间我科肾活检的251例孤立性血尿患儿肾组织病理和临床资料.结果 肾组织病理类型：轻微病变（ML）93例（37.05%）,基本正常62例（24.70%）,IgA肾病（IgAN）52例（20.72%）,薄基底膜病（TBMN）17例（6.77%）,系膜增生性肾炎（MsPGN）16例（6.37%）,局灶节段肾小球硬化（FSGS）5例（1.99%）,局灶增生性肾炎（FPGN）5例（1.99%）,毛细血管内增生性肾炎（EnPGN）1例（0.40%）.镜下血尿组中IgAN比例低于肉眼血尿组（16.48%比31.88%,P＜0.05）;两组IgAN Hass分级Ⅰ、Ⅱ级（83.33%比95.45%,P＞0.05）,Ⅲ级（16.67%比4.55%,P＞0.05）差异均无统计学意义.35例（共检测102例）尿微量白蛋白升高患儿中,IgANⅢ级比例显著高于尿微量白蛋白正常者（14.28%比0%,P＜0.01）;FSGS和FPGN比例高于尿微量白蛋白正常者（20.00%比1.49%,P＜0.01）;轻微病变比例显著低于尿微量白蛋白正常者（28.57%比58.21%,P＜0.01）.结论 儿童孤立性血尿肾脏病理以轻微病变、基本正常、IgAN为常见类型.镜下血尿组中IgAN比例较肉眼血尿组低.尿微量白蛋白升高组病理类型较正常组为重.
Objective To investigate the clinical and renal pathologic features of isolated hematuria in children and the relationship between them. Methods A retrospective review of 251 cases of isolated hematuria undergone renal biopsy from 1995 to 2008 in our hospital were conducted to analyze their clinical manifestations and renal pathologic features. Results Among the pathologic changes, minor abnormalities was found in 93 cases （37.05%）, normal biopsies in 62 cases （24.70%）, IgA nephropathy （IgAN） in 52 cases （20.72%）, thin basement membrane nephropathy （TBMN） in 17 cases（6.77%）, mesangial proliferative giomerulonephritis（MsPGN） in 16 cases （6.37%）, focal segmental glomerulosclerosis （FSGS） in 5 cases （1.99%）, focal proliferative glomerulonephritis （FPGN） in 5 cases （1.99%）, capillary proliferative glomerulonephritis （EnPGN） in 1 case （0.40%）. IgAN was more popular in gross hematuria group than that in microscopic hematuria group （31.88% vs 16.48%, P〈0.05）. zcording to Haas classification, the ratio of class Ⅲ in two groups had no statistical significance （microscopic vs gross： 16.67% vs 4.55%, P〉0.05）. In the 35 cases （102 cases were detected） with elevated urinary microalbuminuria, the proportion of IgAN Ⅲ was significantly higher than those cases without urinary microalbuminuria （14.28% vs 0%, P〈0.01）. There were more FSGS and FPGN （total 20.00%） and less minor abnormalities （28.57%） in these cases as compared to the normal albuminuria cases （1.49% and 58.21%, all P〈0.01）. Conclusion The main pathologic changes of isolated hematuria in children are minor abnormalities, normal and IgAN. IgAN is more popular in the cases with gross hematuria. Elevated urinary microalbuminuria may be an indicator of more serious pathologic changes in children with isolated hematuria.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2010年第10期758-761,共4页
Chinese Journal of Nephrology
关键词
血尿
儿童
回顾性研究
肾脏病理
Hematuria
Children
Retrospective study
Renal pathology
