摘要
目的：探讨过敏性紫癜（HSP）早期肾脏损害临床病理表现与免疫学指标的关系。方法：对365例确诊为过敏性紫癜患儿的临床资料进行回顾性分析。按发病时间〈7d、8～14d、15～30d、31～60d及〉60d进行临床分组（A、B、C、D、E组），并进行尿微量蛋白、尿常规、24小时尿蛋白定量、12小时尿液addis计数、免疫学指标的检查。365例过敏性紫癜患儿发病前有明确感染诱因的82．47％，其中呼吸道感染占70．76％。结果：尿检异常342例（93．69％），其中A组155例（42．47％），尿检异常133例（88．6％）；B组，以尿微量蛋白异常、单纯蛋白尿、血尿为主，尿检异常94例（94．0％）；C、D、E组尿检异常率均达100％，临床以蛋白尿＋血尿为主，病程和肾脏损害程度之间存在一定相关性（P〈0．005）。急性期免疫学指标IgA、IgG、IgM、IgE、C3均高于正常同龄儿童水平的2SD以上，以IgA、C3为主，并与病程的长短无关。结论：过敏性紫癜早期即存在肾脏损害，病程以超过14d者肾脏损害为重；血清IgA、C3在不同病程均较同龄儿有所升高，临床上可作为指导HSPN（紫癜性肾炎）治疗的疗效观察及减药、停药的依据。
Objective： To discuss the relation between clinic appearance of early damage in kidneys of HSP and the index of immunology. Methods： Three hundred and sixty-five HSP children were reviewd and analyzed. According to the pathogenic time 7 d, 14 d, 30 d, 60 d and over 60 d they were divided into five groups, and to test the urine minium albumen, urine routine, 24 h volune of urine albumin, 12 h urine addis count and index of immunology. Result： 82.47% of disease children had definite infectious before pathogenic period, 70.76% of them were respiratory tract infection; there were 342 cases abnormal in urine test （93.69%）, 155 cases were abnormal （42.47%） in the course of disease 〈7 d, there were 133 cases abnormal in urine test （88.6%） ; the abnormal urine minium albumen and hematuria were primary in the course of disease 〈14 d; 100% of urine test were abnormal in the course of disease 〉14 d, albumen urine ＋ hematuria were primary in clinic,there were pertinence between the course of disease and kidneys damage to certain extent （P 〈0.005）. The index of immunology in acute stage IgA, IgG, IgM, IgE, C3 were 2 sd higher than the normal coeval, and IgA, C3 were primary,and were irrelevant with the course of disease. Conclusion： HSP forepart damage existed in kidneys ; the damage in kidneys is primary over 14d of the course of disease; the blood serum, IgA, C3 were higher than coeval to different extent, and there weren＇t statistics meaning, but it was the reference of observing clinical effect and reducing or ceasing medicament.
出处
《新疆医科大学学报》
CAS
2006年第10期963-965,共3页
Journal of Xinjiang Medical University
