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目的 探讨婴幼儿肾小球疾病的病理与临床特点。方法 对经肾活检确诊的 170例婴幼儿肾小球疾病进行分析。结果 原发性肾小球肾炎 16 4例 (占 96 5 % ) ,继发性肾小球肾炎 3例(1 8% ) ,遗传性肾病 3例 (1 8% )。原发性肾小球肾炎中系膜增生性肾炎 6 7例 (40 9% ) ,其他依次为微小病变 37例 (2 2 6 % ) ,IgM肾病 2 9例 (17 7% ) ,毛细血管内增生性肾炎 9例 (5 5 % ) ,膜性肾病8例 (4 9% ) ,轻微病变 6例 (3 7% ) ,IgA肾病 5例 (3 0 % ) ,局灶节段性肾小球硬化 2例 (1 2 % )和C1q肾病 1例 (0 6 % )。继发性肾小球肾炎中紫癜性肾炎 2例 ,药物性肾损害 1例。遗传性肾病中先天性肾病综合征 3例。原发性肾小球肾炎的临床类型肾病综合征 15 0例 (占 88 2 % ) ,其中单纯性肾病 133例 ,肾炎性肾病 17例。结论 婴幼儿肾小球疾病中原发性肾小球肾炎占绝大多数。系膜增生性肾炎和微小病变为最常见的病理类型。原发性肾小球肾炎的临床类型以肾病综合征为主 ,其中单纯性肾病占绝大多数。继发性肾小球肾炎主要为紫癜性肾炎。遗传性肾病以先天性肾病综合征多见 ,仅见于小于 6月的婴幼儿和新生儿。婴幼儿肾脏疾病经皮肾活检对患者的临床诊断和指导治疗是有益的
Objective To investigate the pathological and clinical features of glomerular diseases in infants and young children. Methods A total of 170 cases of infantile glomerular diseases diagnosed by renal biopsy were analyzed. Results 16 4 cases of primary glomerulonephritis (96.5%), 3 cases of secondary glomerulonephritis (18%) and 3 cases of hereditary nephropathy (18%). There were 67 cases (40.9%) of mesangial proliferative glomerulonephritis in primary glomerulonephritis, 37 cases (22.6%) of minimal lesion, 29 cases (17.7%) of IgM nephropathy, 9 cases of proliferative nephritis (5 5%), 8 cases of membranous nephropathy (49%), 6 cases of mild disease (37%), 5 cases of IgA nephropathy (30%), focal segmental glomerulus Two cases were cured (12%) and one case of C1q nephropathy (0 6%). Two cases of purpura nephritis secondary to glomerular nephritis, drug-induced renal damage in 1 case. Hereditary nephropathy in 3 cases of nephrotic syndrome. There were 150 cases of nephrotic syndrome (88%) in primary glomerulonephritis, including 133 cases of simple nephropathy and 17 cases of nephritic nephropathy. Conclusion Infantile glomerular disease in the majority of primary glomerulonephritis. Mesangial proliferative glomerulonephritis and minimal changes are the most common pathological types. The main types of primary glomerulonephritis nephrotic syndrome, of which simple nephropathy accounted for the vast majority. Secondary glomerular nephritis is mainly purpura nephritis. Hereditary nephropathy to more common in patients with nephrotic syndrome, only seen in less than 6 months of infants and newborns. Infantile kidney disease Percutaneous renal biopsy is beneficial for the clinical diagnosis and treatment of patients