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目的 :通过对 6 1例紫癜性肾炎 ( HSPN)患儿临床病理分析 ,以探讨儿童 HSPN的特点 ,并提高其认识。 方法 :对 HSPN患儿进行临床分型及病理分级。临床上分为 U ab型、I- GH型、R- GH型、NS型和 HT型 ;病理分为 ～ 级。以此对临床表现及病理改变特点进行综合分析 ,阐明其临床与病理之间联系。 结果 :临床分型结果显示 ,6 1例患儿中以 U ab型为最多 ,HT型最少。病理分级中以 级为最多 ;R- GH型和 NS型患儿病理分级在 ～ 级者的比例高于 Uab型和 I- GH型 ;免疫复合物沉积以 Ig A+Ig G+Ig M同时存在者比例最高 ,R- GH型和 NS型中Ig A +Ig G+Ig M沉积者的比例高于 U ab型。激素治疗有效组患儿血清白蛋白水平明显高于无效组 ( P<0 .0 5 ) ,无效组患儿蛋白尿水平高于激素治疗有效组。 结论 :儿童 HSPN中临床表现为 NS型和 R- GH型者病理改变相对较重 ,U ab型和 I- GH型患儿病理改变相对较轻 ;免疫复合物沉积为 Ig A+Ig G+Ig M者病理改变相对较重 ;大部分HSPN患儿激素治疗有效 ,血清白蛋白低者激素疗效较差
OBJECTIVE: To investigate the clinical features of HSPN in 61 children with HSPN and to improve their understanding. Methods: The clinical classification and pathological grade of HSPN children. Clinically divided into U ab type, I-GH type, R-GH type, NS type and HT type; pathology is divided into ~ level. In order to make a comprehensive analysis of the clinical manifestations and pathological changes, clarify the link between clinical and pathological. Results: The results of clinical classification showed that U ab type was the most among 6 1 children, and HT type was the least. The pathological grading was the highest grade. The proportion of R-GH-type and NS-type children with pathological grading was higher than that of Uab type and I-GH type. The immunocomplex deposition was accompanied by Ig A + Ig G + Ig M The highest proportion of IgA + Ig G + Ig M deposits in R-GH and NS types than U ab type. Serum albumin levels were significantly higher in the hormone-treated group than in the ineffective group (P <0.05), and proteinuria in the null group was higher than that in the hormone-treated group. CONCLUSIONS: The pathological changes in children with HSPN are relatively severe in clinical manifestations of NS and R-GH types, and pathological changes in U ab and I-GH children are relatively mild. The immunocomplex deposition is Ig A + Ig G + Ig M pathological changes relatively heavy; most of the HSPN treatment of children with hormone therapy, low serum albumin hormone less effective