伴肾小管间质损害的儿童紫癜性肾炎临床病理及预后分析

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Abstract Objective: To investigate the clinicopathological characteristics and prognosis in childhood Henoch-Schönlein purpura nephritis (HSPN) with or without tubulointerstitial lesions. Methods: The clinical and pathological data from 93 children with biopsy-proved HSPN were collected retrospectively in the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from January 2005 to December 2013. The patients were grouped according to the degree of tubulointerstitial lesions, and relationship between their clinical, glomerular parameters, prognosis and tubulointerstitial lesions was analyzed. Results: Ninety-three cases were divided into 3 groups according to the degree of tubulointerstitial lesions, group 1 with no tubulointerstitial lesions (16 cases, 17.2%), group 2 with mild tubulointerstitial lesions (66 cases, 71.0%), and group 3 with severe tubulointerstitial lesions (11 cases, 11.8%). The serum creatinine level (P<0.05) and the mesangial matrix score (P<0.05) was significantly higher in group 3 than that in group 1, and creatinine clearance rates of group 3 was significantly lower than that in group 1 and group 2 (P<0.05). The balloon adhesion score, fibrous crescents score and glomerulosclerosis score of group 3 were significantly higher than that in group 1 and group 2 (P<0.05). Multivariate logistic regression analysis showed that the balloon adhesion was risk factor of tubulointerstitial lesions. In 86 cases with follow-up, 96.5% had clinical normal or mild abnormal urine, 3.5% developed to renal dysfunction, the prognosis of group 3 was significantly worse than that in group 2 (P<0.05). Conclusion: Some HSPN patients may present with tubulointerstitial lesions in pathology at early stage of disease, which is reliable indicator for patients to develop severe glomerular lesion, and the patients with poor prognosis in future.

Key words： children Henoch-Schönlein purpura nephritis tubulointerstitial lesions clinicopathology; prognosis

Received: 24 April 2017

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	HU Yunxia
	HU Xiaohan
	Zhang Yuhua
	HE Xiaoqing
	Chen Lihong
	Yang Qing
	Lin Yiyi
	ZHUANG Jieqiu

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2017/V47/I9/642

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