小儿原发性肾病综合征病理与临床分析

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1、小儿原发性肾病综合征病理与临床分析作者：林娜1,刘运广1,覃远汉2作者单位：(1・?右江民族医学院附属医院儿科，广西?百色7533000;E-mail:linna7766328@163.com2・?广四医科大学第一附属医院儿科，广西?南宁7530021)【摘要】目的分析小儿原发性肾病综合征(PNS)的病理与临床特点，初步探讨其病理类型与临床的关系。方法回顾性分析218例小儿PNS患儿肾穿刺活组织检查的病理和临床资料。结果①最常见的4种病理类型是MsPGN(48.17%)、FSGS(16.51%)、IgAN(13・30%)

2、、MCD(11.47%);@MCD以单纯型肾病综合征为主，MsPGN、FSGS及IgAN以肾炎型肾病综合征为主，差异有高度显著性(X2=32.19,P<0.01)o③病理类型对GC反应的比较差异有高度显著性(X2=62.58,PvO.OOl);④病理类型与预后密切有关，差异有显著tk(X2=104.66,P<0.05)o结论小儿原发性肾病综合征的病理类型多种多样，其病理类型与临床类型关系密切，但没有一对一的对应关系;病理类型对GC反应及疾病预后的判断具有一定的指导价值。【关键词】儿童;肾病综合征;病理学，临床Theana

3、lysisofpathologicalandclinicalcharacteristicinchildrenwithprimarynephroticsyndromeLinNal,LiuYun-guangl,QinYuan-han2(1.DepartmentofPaediatrics,TheAffiliatedHospitaltoYoujiangMedicalUniversityforNationalities,Baise,Guangxi533000,ChinaE-mail:linna7766328@163.com;2.D

4、epartmentofPaediatrics,TheFirstAffiliatedHospitaltoGuangxiMedicalUniversity,Nanning,Guangxi530021,China)Abstract:ObjectiveToApreliminaryinvestigationoftherelationshipbetweenpathologicaltypingandclinicalcharacteristicinchildrenwithprimarynephroticsyndrome(PNS)wasp

5、erformedbyanalyzingtheclinicalrecordsoftheirpathologicalandclinicalfeatures.MethodsAretrospectiveanalysiswasconductedtoanalyzethepathologicalandclinicaldataof218in-patientchildrenwithPNSandallofthemhadreceivedkidneypuncturebiopsyexamination.Results①Thepathologica

6、ltypesthatmostfrequentlyoccurredwere:mesangioproliferativeglomerulonephritis(MsPGN)(48.17%),focalsegmentalglomeralosclerosis(FSGS)(16.51%),immunoglobulinAnephropathy(IgAN)(13.30%),minimalchangedisease(MCD)(11.47%).②TheprincipalmanifestationofMCDwassimplenephrotic

7、syndrome;MsPGN,FSGSandIgANmainlypresentedasnephritisassociatedwithnephroticsyndrome.ComparedMCDtoMsPGN,FSGSandIgAN,therewerestatisticallysignificantdifferencesinnephroticsyndromepresentation(X2=32.19,P<0.01).③Patientswithdifferentpathologicaltypesyieldeddifferent

8、responseratestoglucocorticoid.Therewerestatisticalsignificantdifferences(X2=62.5&P<0.001).④Thepathologicaltypeswerecloselyassociatedwiththeprognosisofthediseas