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本文报告44例小儿于急性肾炎综合征起病后病情迁延和或恶化时的临床和病理所见。此类病儿临床表现有5种:再发性血尿(15例)、持续性肉眼血尿(5例)、蛋白尿及血尿(11例)、肾病综合征(9例)和急进性肾功能减退(4例)。病理可见6种改变:系膜增殖(29例)、内皮系膜增值(4例)、增生硬化(3例)、膜增殖(4例)、轻微病变(3例)、新月体肾炎(1例)。并讨论了临床和病理的相关。最后提出此征起病后如发生持久蛋白尿、肾病综合征或肾功能减退时应及时行肾活检,其结果有助于了解预后及指导治疗。
This article reports 44 cases of children with acute nephritic syndrome onset and worsening of the disease or clinical and pathological findings. There are five clinical manifestations of these children: recurrent hematuria (15 cases), persistent gross hematuria (5 cases), proteinuria and hematuria (11 cases), nephrotic syndrome (9 cases) and acute progressive renal dysfunction (4 cases). There are 6 kinds of pathological changes: mesangial proliferation (29 cases), endothelial mesangial proliferation (4 cases), proliferative sclerosis (3 cases), membrane proliferation (4 cases), minor lesions (3 cases), crescentic nephritis example). And discussed the clinical and pathological correlation. Finally put forward this sign of illness such as persistent proteinuria, nephrotic syndrome or renal dysfunction should prompt renal biopsy, the results help to understand the prognosis and guide treatment.