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1、中國中西醫(yī)結(jié)合腎病雜志2010年12月第lll卷第期—CJITWN,Dece—mber2010,Vo1.1—1,N—o.12·1077·成人紫癜性腎炎的臨床病理分析及轉(zhuǎn)歸熊子波①羅瓊①熊祖應(yīng)①梁偉①廖瑾嵐①鄭磊①(摘要]目的:了解深圳地區(qū)成人紫癜性腎炎的臨床特征及其與腎臟病理的聯(lián)系;探討其轉(zhuǎn)歸及影響因素。方法:回顧性分析2001年1月2009年12月間經(jīng)我院臨床及腎活檢確診的紫癜性腎炎52例,對其臨床資料、病理特征及轉(zhuǎn)歸進行統(tǒng)計分析。結(jié)果:(1)成人紫癜性腎炎多好發(fā)于30歲以下,40歲以后患者高血壓的發(fā)
2、生率較高。(2)臨床分型以蛋白尿+血尿型(59.6%)最多見,其次為單純性血尿(21.2%)和腎病綜合征型(19.2%);病理分級以Ⅱ級(44.2%)及Ⅲ級(36.5%)多見。(3)腎小管間質(zhì)病變與腎小球慢性病變及活動病變的相關(guān)系數(shù)分別為0.587(P<0.01)和0.260(P>0.05);蛋白尿越多的患者,其腎小球活動病變積分就越高。(4)多因素分析顯示療效與腎小球硬化率及腎小管間質(zhì)病變呈負(fù)相關(guān)。結(jié)論:深圳地區(qū)成人紫癜性腎炎發(fā)病相對年輕,臨床以蛋白尿+血尿型多見,病理以Ⅱ、Ⅲ級常見;蛋白尿的嚴(yán)重程度
3、與腎小球活動病變關(guān)系密切;影響療效的主要因素為腎小球慢性病變及腎小管間質(zhì)病變程度。(關(guān)鍵詞]紫癜性腎炎r臨床表現(xiàn)病理學(xué)成人TheClinicalandPathologicalCharacteristicsandPrognosisinAdultswithHenoch——SchonleinPurpuraNephritisXIONGZI,LUOQiong,XIONGZuying,etalRenalDivisionPekingUniversityShenzhenHospital,Shenzhen(518000)
4、ABSTRACtObjective:TodiscusstheclinicalandpathologicalfeaturesinadultswithHenoch—Schonleinpurpuranephritis(HSPN),andtoevaluatetheprognosispredictors.Methods:Clinical,pathologicalandoutcomeofrecordsof52adultswithHSPNfromJanuary2001toI~cember2009wereretrosp
5、ectivelyreviewed.ResulIs:(1)Themajorityofpatientswereunderthe30yearsold;TheincidenceofhypertensionW&Shigherafter40yearsold.(2)Mostofpatientspresentedhematuriaandpmteinunia(59.6%),andtheotherexhibitedisolatedhematuria(21.2%)andnephroticsyndrome(19.2%);Mos
6、t0fpathologicalclassifica—tionsweregradeII(44,2%)andfJl(36.5%).(3)Therehasexcellentcorrelationsbetweentubulointerstionlesionsandglomerulorchronic1esions(P<0.01).Whiletherewerenosingnificantdifferencebetweentubulointerstitiallesionsandglomeruloractive1~io
7、ns(P>0.05).Theseverityofproteinuriahasexcellentcorrellationswithglomeruloractvelesions.(4)Alogisticmultivariateanalysisshowedsignificantcorrelationsbetweentheraputiceffectsandglomerulorchroniclesionsandtubulointerstitiallesions.Conclusion:Mostofpatientsw
8、ithHSPNinShenZhenwereunderthe30yearsoldandpresentedhematuriaandproteinunia.Grade1IandIIofpathologicalclassificationhavebeenseeninthemajorityofHPSNinadults.Theseventyofproteinuriaisagoodmarkerforglomeru—laractivelesions.Glo