儿童肾小球疾病临床病理研究

为了探讨肾小球疾病的病理类型与临床治疗的关系，对肾小球疾病１３１例行肾穿刺活组织检查。其中原发性肾小球疾病１２０例，继发性肾小球疾病１１例，前者以系膜增生性肾小球肾炎（ＭｓＰＧＮ）居多，占２９．２％，其次是ＩｇＡ肾病（ＩｇＡＮ），占２５．８％。临床诊断与病理诊断符合率为５７．２％。治疗后，随访６个月至６年，总痊愈率和好转率为７６．７％，病理类型中的微小病变（ＭＣＮＳ）、轻度ＭｓＰＧＮ、ＩｇＭ肾病（ＩｇＭＮ）、毛细血管内增生性肾小球肾炎（ＥｎＰＧＮ）等的疗效及预后好，膜增生性肾小球肾炎、重度ＭｓＰＧＮ及组织损害严重的ＩｇＡＮ等疗效差。提示治疗效果、预后与病理类型密切相关

THE CLINICOPATHOLOGIC STUDY OF GLOMERULAR DISEASES IN CHILDREN

To determine the relationship between the pathology and clinic as well as treatmet,renal biopsy was done in 131 pediatric patients with glomerular diseases. In the total of 120 cases of primary glomerulonephritis, mesangial proliferative glomerulonephritis(MsPGN) was 29. 2% and IgA nephropathy(IgAN) 25. 8%. There were 11 cases of secondary glomerulonephritis. Accordant rate of clinical diagnosis with pathological diagnosis was 57. 2%. The patients have been followed for 6 months to 6 years. the total remission rate and cure rate was 76. 7%. Therapeutic effects and prognosis in minimal change nephrotic syndrome(MCNS). mild MsPGN, IgM nephropathy (IgMN ) and endocapillary proliferative glomerulonephritis(EnPGN) were better than those in membranoproliferative glomerulonephritis,(MPGN), sclerosing glomerulonephritis, MsPGN and IgAN with severe histological changes. The results demonstrated that therapeutic effects and prognosis was related to histopathological types of glomerular diseases.