血尿患儿肾活检病理与临床分析

目的 探讨无症状肾小球性血尿患儿病理与临床的特点.方法 对无症状肾小球性血尿患儿25例进行肾活检病理检查,同时行24 h尿蛋白定量等临床指标检测,并比较分析.结果 在无症状肾小球性血尿患儿中IgAN最多见,其次为MsPGN;IgAN以中度系膜增生为主,有肾小管病变、肾小球硬化改变,并有个别新月体形成.本组中IgAN24h尿蛋白定量较MsPGN多,有统计学差异.结论 对无症状血尿应该积极诊治,特别是在拟诊IgA肾病并伴有蛋白尿的患儿中,肾活检是有必要的,并对无症状血尿的明确病因、指导治疗和判断预后有重要的意义.

Clinical and pathological features of children with hematuria

Objective] To investigate clinical and pathological features of children with asymptomatic glomerular hematuria.Method] We had the renal biopsy and clinical serum test including urian protein quantitation per day etc.for 25 children with asymptomatic glomerular hematuria,and observed the relationship between them.Results] The major pathological types of the patients with asymptomatic glomerular hematuria were IgAN and MsPGN.The main pathological features of IgAN were the midrange mesangial proliferation with or without renal tubule degeneration,glumerular sclerosis and crescent formation.The IgAN patients in our group had the more urine protein quantitation per day than the MsPGN children.Conclusion] We should have active diagnosis and treatment for the children with asymptomatic glomerular hematuria,especially the children like IgAN with more urine protein quantitation,renal biopsy was important about the diagnosis,treatment and prognosis of asymptomatic glomerular hematuria.