临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (6): 511-.doi: 10.3969 j.issn.1000-3606.2015.06.003

• 泌尿系统疾病专栏 • 上一篇    下一篇

从IgA 血管炎角度分析儿童IgA 肾病和紫癜性肾炎的临床病理

段翠蓉1,2,肖慧捷1,钟旭辉1,王芳1,管娜1,刘晓宇1,丁洁1   

  1. 1. 北京大学第一医院儿科( 北京 100034);2. 湖南省儿童医院(湖南长沙 410007)
  • 收稿日期:2015-06-15 出版日期:2015-06-15 发布日期:2015-06-15
  • 通讯作者: 肖慧捷 E-mail:huijiexiao2@hotmail.com

Analysis of clinical pathology of the IgA nephropathy and purpura nephritis in children from the perspective of IgA vasculitis

DUAN Cuirong 1,2, XIAO Huijie1, ZHONG Xuhui1, WANG Fang1, GUAN Na1, LIU Xiaoyu1, DING Jie1   

  1. 1. Department of Pediatrics, Peking University First Hospital, Beijing 100034, China; 2. Hunan Children's Hospital, Changsha 410007, Hunan, China
  • Received:2015-06-15 Online:2015-06-15 Published:2015-06-15

摘要: 目的 从IgA血管炎角度分析器官特异性IgA血管炎(IgA肾病)与系统性IgA血管炎(紫癜性肾炎)临床和病理的差异。方法 回顾性分析1993年6月至2014年11月住院的IgA肾病和紫癜性肾炎患儿的临床、病理和转归。结果 IgA肾病患儿405例,男256例、女149例,男女比例为1.7:1,平均发病年龄(10.2±2.8)岁;临床类型以肾病综合征最多,占31.6%,其次为血尿和蛋白尿型占27.9%。紫癜性肾炎患儿548例,男329例、女219例,男女比例为1.5:1,平均发病年龄(10.2±3.1)岁,临床类型以血尿和蛋白尿型最多,占60.9%,肾病综合征占21.4%。未发现IgA肾病因病情加重或反复进展至系统性血管炎的病例。结论 IgA肾病和过敏性紫癜的起病诱因、发病年龄、临床表现多有一致或重叠,二者在发病机制上也有一定共性,但IgA肾病更可能还有肾脏局部免疫紊乱等参与发病。

Abstract: Objectives To analysis clinical pathology of organ specific IgA vasculitis (IgA nephropathy) and systemic IgA vasculitis (allergic purpura) of purpura nephritis in children. Methods Clinical and pathological data of hospitalized pediatric patients of IgA nephropathy and purpura nephritis were retrospectively analyzed from June 1993 to November 2014. Results There were 405 patients of IgA nephropathy (256 males and 149 females). The ratio of male to female was 1.7:1. The average age was 10.2±2.8 years. The nephrotic syndrome (31.6%) was the most common clinical type, followed by hematuria and proteinuria (27.9%). There were 548 patients of purpura nephritis, 329 males and 219 females. The ratio of male to female was 1.5:1. The average age was 10.2±3.1 years. The hematuria and proteinuria (61.6%) was the most common clinical type, followed by nephrotic syndrome (21.4%). None of the IgA nephropathy progressed to systemic vasculitis (allergic purpura). Conclusions The causes, onset ages and clinical manifestations of IgA nephropathy and allergic purpura may be consistent or overlap, but none of IgA nephropathy (organ specificity IgA vasculitis) progressed to allergic purpura (systemic IgA vasculitis). IgA nephropathy might have more renal immune disorder mechanisms involved in its pathogenesis.