论文部分内容阅读
目的回顾性分析早期尿检正常型紫癜性肾炎患儿肾活检病理及预后情况,探讨早期肾活检的重要性。方法选择早期尿检正常但尿微量蛋白阳性的紫癜性肾炎69例患儿,按照以早期尿微量蛋白持续阳性或病程中出现尿蛋白作为肾活检指标,分为2组:早期肾活检组(n=29)、肾活检组(n=40),探讨其肾活检病理及预后差别。结果所有早期尿检正常型紫癜性肾炎,反复尿微量蛋白异常≥3次,肾活检发现肾脏均有不同程度损害,其中Ⅱ级37例,Ⅲ级27例,Ⅳ级5例;早期肾活检组的病理损害程度低于肾活检组(P<0.05),并且早期肾活检组9例病程中出现蛋白尿,治疗后尿蛋白转阴时间(14.43±10.21)d,肾活检组20例病程中出现蛋白尿,治疗后尿蛋白转阴时间(31.26±19.65)d,早期肾活检组蛋白尿转阴时间显著短于肾活检组(P<0.01)。结论以尿微量蛋白持续阳性作为肾活检指标,进行早期肾活检,能及早发现肾脏损害,改善预后。
Objective To retrospectively analyze the pathology and prognosis of renal biopsy in children with early-stage urinalysis and to explore the importance of early renal biopsy. Methods 69 cases of purpura nephritis with normal urinalysis and urinary microalbuminuria were enrolled in this study. According to the urinary protein as the index of early urinary microalbuminuria or urinary protein during the course of disease, the patients were divided into two groups: the early renal biopsy group (n = 29), renal biopsy group (n = 40), to explore the pathological and prognosis of renal biopsy differences. Results All early urine purpura nephritis, repeated urinary micro-protein abnormalities ≥ 3 times, kidney biopsies were found to varying degrees of renal damage, including 37 cases of grade Ⅱ, Ⅲ grade 27 cases, Ⅳ grade 5 cases; early renal biopsy group (P <0.05). In the early renal biopsy group, proteinuria occurred in 9 patients during the course of the disease. Urine protein negative conversion time (14.43 ± 10.21) d after treatment and protein expression in 20 patients during renal biopsy Urine, urinary protein after treatment negative conversion time (31.26 ± 19.65) d, early renal biopsy histological urine negative conversion time was significantly shorter than the renal biopsy group (P <0.01). Conclusion Persistent positive urine microalbumin as an indicator of renal biopsy, early renal biopsy, early detection of kidney damage and improve prognosis.