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目的探讨儿童肾病综合征中医证型与肾脏病理类型的关系。方法收集符合纳入标准的410例肾病综合征患儿,在肾穿刺活检前24h内进行中医辨证分型,分析不同中医证型患儿肾脏病理类型的分布。结果肺脾气虚型、脾虚湿困型、脾肾阳虚型、肝肾阴虚型患儿光镜病理类型均以轻微病变(MCNS)、系膜增生性肾小球肾炎(MsPGN)型多见;气阴两虚型患儿以MCNS、局灶节段硬化(FSGS)多见。各证型的肾脏病理类型分布差异有统计学意义(P<0.01)。所有证型患儿免疫病理均以无免疫复合物型为主,均在50%以上,而IgA+M+G+C3型最少,各证型的肾组织免疫荧光类型分布差异无统计学意义(P>0.05)。结论不同证型的肾病综合征患儿在光镜肾脏病理类型分布明显不同,在免疫病理类型分布无明显差异。
Objective To investigate the relationship between TCM syndromes and renal pathological types in children with nephrotic syndrome. Methods A total of 410 children with nephrotic syndrome who met the inclusion criteria were enrolled in this study. The TCM syndrome differentiation was performed within 24 hours before renal biopsy, and the distribution of renal pathology in children with different TCM syndromes was analyzed. Results The pathological types of lung-spleen qi-deficiency type, spleen-qi damp-sleep type, spleen-kidney yang-deficiency type and liver-kidney yin-deficiency type were mild type (MCNS) and mesangial proliferative glomerulonephritis type ; Qi and Yin deficiency in children with MCNS, focal segmental sclerosis (FSGS) more common. There were significant differences in the distribution of renal pathological types in all syndromes (P <0.01). Immunopathology in all children with syndromes were mainly immunocomplex type, were more than 50%, while IgA + M + G + C3 type at least, the type of kidney tissue immunofluorescence showed no significant difference in distribution ( P> 0.05). Conclusion The distribution of renal pathological types of patients with different syndromes of nephrotic syndrome is obviously different. There is no significant difference in the distribution of immunopathological types.