潘晓芬 1杨赛 1刘玉玲 1李小琳 1付四毛 1周涛 1雷辛衍 1罗序峰 1林国模 1黄东明1
作者信息
- 1. 南方医科大学附属中山市博爱医院儿科，广东中山528403
- 折叠
摘要
Abstract
Objective To explore the clinical features and prognosis of childhood primary glomerulopathy with IgM deposition .Methods The clinical data of 83 children with primary glomerulopathy , who were hospitalized and underwent puncture biopsy in pediatric nephrology of Zhongshan Boai Hospital during May 2009 to June 2015, was analyzed.According to whether there was IgM deposition in renal tissue pathology immunofluorescence test , patients were divided into IgM group ( n =49 ) and non-IgM group ( n =34 ) , and their clinical features, pathological characteristics , curative effect and prognosis were analyzed .Results Clinical diagnosis indicated 37 cases of simple hematuria, 30 cases of nephrotic syndrome, 9 cases of acute nephritic syndrome, and 7 cases of proteinuria.In IgM group mesangial proliferative glomerulonephritis was the major lesion and occupied 59.2%(29 cases), which was significantly higher than that (17.6%, 6 cases) in non-IgM group (χ2 =14.200, P<0.05).However, rate of minor glomerular abnormalities in IgM group (28.6%,14) was lower than that in non-IgM group (70.6%, 24) (χ2 =14.280, P<0.05).In IgM group and non-IgM group there were 3 and 4 cases of focal segmental glomerulosclerosis , and 3 and 0 case of membrano-proliferative glomerulonephritis , respectively .There were 4 cases of basement membrane thickening and 4 cases of small artery wall lesions in IgM group , but no case was found in non-IgM group.Totally 44 cases were provided with corticosteroids , and the sensitive rate to steroid was 56.0% and 73.7% in IgM group and non-IgM group, respectively.However, in drug resistance, dependence or frequently relapse , the rate was 44.0% and 26.3%, respectively, and there was no significant difference between two groups (P>0.05).Follow-up for 6 months to 6.5 years revealed that there were 19 cases of remission (38.8%) in IgM group and 22 cases (62.9%) in non-IgM group, respectively, and the difference between two groups was significant (χ2 =5.339,P=0.020).Conclusion The clinical features of primary glomerulopathy with IgM deposition are similar to those without deposition .Mesangial proliferative glomerulonephritis is the majority in renal pathology , and a few cases may occur basement membrane thickening and small artery wall lesions .Treatment responses to steroid is similar .Remission rate of hematuria and proteinuria is low, so a long-term tracking is needed .关键词
IgM沉积/原发性肾小球疾病/儿童/临床特征Key words
IgM deposition/primary glomerulopathy/childhood/clinical features分类
医药卫生
