本文選題：兒童 + 狼瘡性腎炎��； 參考：《廣西醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的總結(jié)兒童狼瘡性腎炎（lupus nephritis，LN）的臨床表現(xiàn)與腎臟病理特點(diǎn)，探討其臨床表現(xiàn)與腎臟病理之間的相關(guān)性，為指導(dǎo)臨床治療提供幫助。 方法收集2005年1月至2010年12月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院住院并進(jìn)行腎活檢確診的57例LN患兒的臨床和病理資料，根據(jù)WHO2003年診斷標(biāo)準(zhǔn)進(jìn)行腎臟病理分型，回顧性分析其臨床表現(xiàn)、實(shí)驗(yàn)室檢查和腎臟病理資料。 結(jié)果⑴57例LN患兒男14例（24.6%），女性43例（75.4%），男:女=1:3.07，發(fā)病年齡為6~15歲，平均（12±2.64歲）。⑵以腎臟受累為首發(fā)癥狀者37例（65.5%），最常見(jiàn)的臨床分型為腎病綜合征型28例（49.1%），孤立性血尿和(或)蛋白尿型15例（26.3%），其次為急性腎炎型8例（14%），慢性腎炎型3例，急進(jìn)性腎炎型2例。腎外癥狀包括蝶形紅斑（57.9%），發(fā)熱（56.1%），關(guān)節(jié)疼痛（36.8%），光敏感（21.1%）。實(shí)驗(yàn)室檢查：抗核抗體陽(yáng)性（94.7%），低補(bǔ)體血癥（91.2%），貧血（80.7%），抗dsDNA陽(yáng)性（75.4%），高IgG血癥（49.1%），電解質(zhì)紊亂（45.6%）。⑶腎臟病理分型以Ⅳ型最常見(jiàn)（32例，56.1％），其次為Ⅱ型（11例，19.3％），再次Ⅲ型、Ⅴ型、Ⅴ+Ⅲ型和Ⅴ+Ⅳ型（各3例，5.3％），Ⅰ型2例（3.5％），Ⅵ型未見(jiàn)。⑷臨床分型為NS型的28例患兒，病理類型大多為Ⅳ型（78.6％）；臨床分型為孤立性血尿和(或)蛋白尿型的11例，病理類型呈多樣性。Ⅳ型LN的臨床類型以腎病綜合征型為主（68.8%）。⑸相關(guān)分析：病理分型與臨床分型無(wú)顯著相關(guān)性，病理分型與腎外癥狀和實(shí)驗(yàn)室檢查指標(biāo)無(wú)顯著相關(guān)性。 結(jié)論兒童LN的臨床表現(xiàn)與腎臟病理改變多種多樣，臨床分型以腎病綜合征型、孤立性血尿和（或）蛋白尿型為多見(jiàn)，病理分型最常見(jiàn)為Ⅳ型。臨床分型與病理分型之間具有一定的相關(guān)性，，但沒(méi)有一對(duì)一的對(duì)應(yīng)關(guān)系。
[Abstract]:Objective to summarize the clinical and pathological features of lupus nephilitis in children with lupus nephritis (LN) and to explore the correlation between its clinical manifestations and renal pathology in order to provide guidance for clinical treatment. Methods from January 2005 to December 2010, 57 cases of LN children who were hospitalized in the first affiliated Hospital of Guangxi Medical University and confirmed by renal biopsy were collected. According to the annual diagnostic criteria of WHO2003, renal pathological classification was performed. The clinical manifestation, laboratory examination and renal pathological data were analyzed retrospectively. Results among 157 cases of LN, 14 cases were male (24.6%) and 43 cases were female (75.45.47%), male: female 1: 3.07, the age of onset was 615 years old. The average age of 12 鹵2.64 years old was 12 鹵2.64 years old. 37 cases with kidney involvement as the first symptom, 28 cases with nephrotic syndrome type and 49.1%, 15 cases with isolated hematuria and / or proteinuria type, 8 cases with acute nephritis type and 3 cases with chronic nephritis type, were diagnosed as acute nephritis type (n = 8) and chronic glomerulonephritis type (n = 3), the most common clinical types were nephrotic syndrome type (n = 28), isolated hematuria type (n = 15) and / or proteinuria type (n = 15). Two cases of acute nephritis. The extrarenal symptoms included butterfly erythema 57.9%, fever 56.1%, joint pain 36.8%, light sensitivity 21. 1%. Laboratory examination showed that the positive rate of anti-nuclear antibody was 94.7%, hypocomplement was 91.2%, anemia was 80.7, dsDNA positive was 75.4%, high IgG was 49.1%, electrolyte disorder was 45.63.The most common renal pathological classification was type 鈪

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