31例尿常规正常的过敏性紫癜肾脏病理改变
The renal pathological change of 31 Henoch-Sch(o)nlein purpura with normal urine routine
摘要目的 探讨尿常规正常的过敏性紫癜患儿肾脏病理情况.方法 对本院2005年至2010年小儿肾病专科31例住院尿常规正常的过敏性紫癜患儿进行肾穿刺活检,部分病例检测尿微量白蛋白.结果 本组31例患儿存在不同程度的肾脏病理损害,光镜结果显示病理分级Ⅱ-Ⅵ级不等,其中Ⅱ级占35.48%(11/31),Ⅲ级占54.83% (17/31),Ⅳ级、Ⅴ级及Ⅵ级各占3.23%(1/31).免疫荧光病理显示单纯IgA沉积型占48.38%( 15/31),IgA+ IgG沉积型占19.36% (6/31),IgA+ IgM沉积型占19.36%(6/31),IgA+ IgG+ IgM沉积型占12.90%(4/31).14例患儿行尿微量白蛋白检测,其中10例(10/14,占71.43%)高于正常值.结论 尿常规检查正常的过敏性紫癜患儿可能已经存在肾脏病理改变,尿微量白蛋白是早期发现肾损害有意义的指标.
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abstractsObjective To research Henoch-Schonlein purpura purpura (HSP) and renal pathology in children.Methods 31 hospitalized HSP children that with normal urine routine and accepted renal biopsy in our hospital.Results There were different levels of kidney pathological damage in this group of 31 cases,the results of light microscope were from grade Ⅱ to grade Ⅵ The proportion was grade Ⅱ(35.48%,11 of 31),grade Ⅲ (54.83%,17 of 31),and grade Ⅳ,Ⅴ and Ⅵ (each 1 case of 31,3.23% ).lmmunofluorescence pathology results were showed as following:merely IgA depositional (48.38%,15 of 31 ),IgA + IgG depositional ( 19.36%,6 of 31 ),IgA + IgM depositional ( 19.36%,6of 31 ),IgA + igG + IgM depositional ( 12.90%,4 of 31 ).Microalbuminuria had been founded in 14 cases,and the microalbuminuria level of 10 cases were higher than normal value( 10 of 14,71.43% ).Conclusions HSP children had renal pathologic dysfunction,even the urine routine were normal,and the detection of urine microalbumin was a significant marker in the early stage.
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