本文選題：兒童 + C腎小球腎炎　； 參考：《中國實用兒科雜志》2017年05期

【摘要】：目的分析6例兒童C3腎小球腎炎的臨床表現(xiàn)、病理特征及治療反應(yīng),旨在提高兒科醫(yī)生對此病的認識和處理。方法對2010年9月至2016年6月在吉林大學(xué)第一醫(yī)院小兒腎病科確診為C3腎小球腎炎且有完整臨床資料的6例患兒的臨床表現(xiàn)、病理改變、療效及預(yù)后進行回顧性分析。結(jié)果(1)臨床表現(xiàn)及實驗室檢查:以血尿為首發(fā)癥狀2例,以血尿和蛋白尿為首發(fā)癥狀4例;其中表現(xiàn)為腎炎綜合征3例,腎病綜合征1例;6例患兒補體C3均降低;補體C4均正常;(2)病理特點:6例患兒免疫熒光均可見補體C3強陽性沉積;光鏡下表現(xiàn)為系膜增生性腎小球腎炎5例,表現(xiàn)為毛細血管內(nèi)增生性腎小球腎炎1例;電鏡下3例可見電子致密物沉積,3例未見電子致密物沉積;(3)治療及預(yù)后;均予腎炎常規(guī)治療,2例有新月體形成者加用糖皮質(zhì)激素治療。隨訪6~42個月,預(yù)后較好。結(jié)論本組C3腎小球腎炎患兒以血尿和(或)蛋白尿為主要表現(xiàn),免疫熒光見C3強陽性沉積,光鏡表現(xiàn)多以系膜增生性腎小球腎炎為主,電鏡可表現(xiàn)為電子致密物沉積,短期預(yù)后較好。
[Abstract]:Objective to analyze the clinical manifestations, pathological features and therapeutic responses of 6 children with C3 glomerulonephritis, in order to improve the understanding and treatment of the disease by pediatricians. Methods from September 2010 to June 2016, 6 cases of C3 glomerulonephritis diagnosed in the Department of Pediatric Kidney, first Hospital of Jilin University, with complete clinical data, were retrospectively analyzed. Results (1) Clinical manifestation and laboratory examination: hematuria was the first symptom in 2 cases and hematuria and proteinuria as the first symptom in 4 cases. Complement C4 was normal, (2) the positive deposition of complement C3 was observed in all of the 6 cases of children with microscopical pathological features, 5 cases with Mesangial proliferative glomerulonephritis and 1 case with endocapillary proliferative glomerulonephritis under light microscope. Electron microscopic examination showed that 3 cases had no electron dense matter deposition; (3) treatment and prognosis; 2 cases with crescent formation were treated with glucocorticoid plus glucocorticoid. Follow-up for 6 ~ 42 months showed a good prognosis. Conclusion in this group of children with C3 glomerulonephritis, hematuria and / or proteinuria are the main manifestation, immunofluorescence is strong positive deposition of C3, light microscope is mainly Mesangial proliferative glomerulonephritis, electron microscope can show electron dense deposition. The short-term prognosis is good.
【作者單位】： 吉林大學(xué)第一醫(yī)院小兒腎病科;
【分類號】：R726.9

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