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目的 探讨肾小管间质病变对儿童过敏性紫癜肾炎 (HSPN)预后的影响。方法 对 30例HSPN患儿进行肾活组织检查 (肾小管间质病变分级 -～ ++++) ,并测定尿 β2 微球蛋白 (β2 MG)及尿视黄醇结合蛋白(RBP)值 ,作为观察肾小管间质病变的实验室指标。平均随访 4 8个月 ,随访结果分 4类 :正常、轻微尿异常、活动性肾脏病、肾功能不全。结果 30例患儿中随访结果正常者 12例 ,轻微尿异常者 12例 ,活动性肾脏病者 6例 ,无一例出现肾功能不全。肾活检肾小管间质病变程度与预后的相关性分析r =0 76 ,P <0 0 0 1。而且 ,随访结果为活动性肾脏病者病初尿 β2 MG及尿RBP值较随访结果正常和轻微尿异常者明显增高 (P <0 0 0 1)。结论 肾小管间质病变对判断儿童HSPN的预后十分重要。
Objective To investigate the effect of tubulointerstitial lesions on the prognosis of children with Henoch-Schonlein purpura nephritis (HSPN). Methods Thirty patients with HSPN were examined by renal biopsy (tubulointerstitial lesions grade ~ ~ ++++) and urine β2 microglobulin (β2 MG) and urinary retinol binding protein (RBP) As a laboratory measure of tubulointerstitial lesions. The average follow-up 48 months, follow-up results were divided into four categories: normal, mild urinary abnormalities, active kidney disease, renal insufficiency. Results Of the 30 children, 12 were normal follow-up, 12 were mild urine abnormalities, and 6 were active kidney disease. None of them had renal insufficiency. Renal biopsy tubulointerstitial lesions and prognosis of the correlation analysis r = 0 76, P <0 0 0 1. Moreover, the outcome of follow-up was significantly higher in patients with active kidney disease than those with normal follow-up and mild urinary abnormalities (P <0.01). Conclusions Tubulointerstitial lesions are important in judging the prognosis of children with HSPN.