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本文回顾分析了成人41例紫癜性肾炎(HSP)患者临床分型、病理与预后的关系,将其分为反复发作性肉眼血尿型(R-GH),尿检异常型(Uab),肾病综合征型(NS),高血压型(HT),急进性肾炎型(RPGN)5型。而以Uab、HT型多见。按HSP的病理改变分为Ⅰ～Ⅵ级,25例远期随访(范围10～92个月;X42.1个月)结果显示:临床上高血压与大量蛋白尿是影响预后的重要因素,而反复肉眼血尿则显示预后良好,50%Ⅳ～Ⅵ级病变者治疗无效,进入临床分级C、D级。作者认为肾活检不仅有助于HSP的诊断,而且是了解预后的重要窗口。
This article retrospectively analyzed the relationship between the clinical classification, pathology and prognosis of 41 adult patients with purpura nephritis (HSP). The patients were divided into repeated episodes of gross hematuria (R-GH), abnormal urinalysis (Uab), nephrotic syndrome (NS), hypertensive (HT), and acute nephritis (RPGN) type 5. Uab, HT type more common. According to the pathological changes of HSP, the patients were divided into Ⅰ ~ Ⅵ stage, 25 cases of long-term follow-up (range 10-92 months; X42.1 months) showed that hypertension and massive proteinuria were important prognostic factors Repeated gross hematuria showed a good prognosis, 50% Ⅳ ~ Ⅵ lesions ineffective treatment, into the clinical classification of C, D level. The author believes that renal biopsy will not only help the diagnosis of HSP, but also an important window to understand the prognosis.