论文部分内容阅读
目的探讨儿童肾脏疾病的病理特点及其与临床表现的关系。方法回顾性分析2002年2月-2010年6月在江西省儿童医院行肾活检的757例肾病患儿的病理及临床资料。将肾活检组织分别行光镜、免疫荧光、免疫组织化学及电镜检查。肾活检组织均作苏木精-伊红(HE)、过碘酸雪夫反应(PAS)、六胺银(PASM)及Masson染色;免疫荧光检测IgG、IgA、IgM、C3、C4、C1q。有乙型肝炎病毒感染证据者肾组织同时行乙型肝炎表面抗原(HBsAg)、乙型肝炎e抗原(HBeAg)、乙型肝炎核心抗原(HBcAg)免疫组织化学。参照中华医学会肾脏病分会2000年制定的标准进行病理分型,结合临床和病理资料进行统计分析。结果 1.肾活检病例757例中原发性肾小球疾病537例(70.97%),其中肾病综合征265例(49.35%),孤立性血尿99例(18.44%);继发性肾小球疾病211例(27.84%),其中紫癜性肾炎144例(68.25%),乙肝相关性肾炎47例(22.27%);遗传性肾小球疾病9例(1.19%)。2.原发性肾小球疾病病理类型最多的是系膜增生性肾小球肾炎277例(51.58%);继发性肾小球疾病中紫癜性肾炎最多,为144例(68.25%),其病理分级以Ⅱb~Ⅲb为主,占79.17%;遗传性肾小球疾病中A lport综合征8例;薄基底膜肾病1例。结论江西地区儿童肾脏疾病以原发性肾小球疾病为主,病理改变以系膜增生性肾小球肾炎占绝大多数;继发性肾小球疾病中除以紫癜性肾炎为主外,乙肝相关性肾炎并不少见。
Objective To investigate the pathological features of children with kidney disease and its relationship with clinical manifestations. Methods The clinical data and clinical data of 757 children with nephropathy who underwent renal biopsy in Jiangxi Provincial Children’s Hospital from February 2002 to June 2010 were retrospectively analyzed. The renal biopsy were performed light microscopy, immunofluorescence, immunohistochemistry and electron microscopy. The renal biopsy tissues were stained with hematoxylin and eosin (HE), periodic acid Schiff reaction (PAS), hexamine silver (PASM) and Masson. Immunofluorescence was used to detect IgG, IgA, IgM, C3, C4 and C1q. Renal tissue with evidence of hepatitis B virus infection also had hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis B core antigen (HBcAg) immunohistochemistry. Reference to the Chinese Medical Association Nephrology Branch 2000 standards for pathological classification, combined with clinical and pathological data for statistical analysis. Results 1. Among the 757 cases of primary renal biopsy, 537 cases (70.97%) had primary glomerular disease, including 265 cases of nephrotic syndrome (49.35%) and 99 cases of isolated hematuria (18.44%); secondary glomeruli There were 211 cases of disease (27.84%), including 144 cases of purpuric nephritis (68.25%), 47 cases of hepatitis B-associated nephritis (22.27%) and 9 cases of hereditary glomerular disease (1.19%). 2. The primary pathological type of primary glomerular disease is mesangial proliferative glomerulonephritis 277 cases (51.58%); secondary glomerular disease in the most purpura nephritis, 144 cases (68.25%), The pathological grade Ⅱb ~ Ⅲb based, accounting for 79.17%; hereditary glomerular disease in the A lport syndrome in 8 cases; thin basement membrane nephropathy in 1 case. CONCLUSIONS: Kidney diseases in children in Jiangxi Province mainly include primary glomerular diseases and pathological changes account for the vast majority of mesangial proliferative glomerulonephritis. Secondary glomerular diseases are mainly purpura nephritis, Hepatitis B-related nephritis is not uncommon.