Analysis Of Pathological Characteristics And Laboratory Tests In Adult And Children With Henoch-schonlein Purpura Nephritis

Objective:The research aimed at to analyze the correlation between thepathological characteristics and laboratory of the adult and childrenpatients with allergic purpura nephritis, and provide the mechanistic basisfor the treatment of Henoch-Schonlein Purpura NephritisMethods:139cases of Henoch-Schonlein purpura nephritis (HSPN) patientswere selected for retrospectively study. The patients were diagnosed byrenal biopsy from September2010and December2014in the FirstHospital of Jilin University, Including71children (4＜age≤14) and68adult (age≥18) cases. The cases were graded according to theInternational Association of kidney disease study group (ISKDC)classification standard. The patients were analysed between adult andpediatric renal biopsy pathological classification and characteristics andthe examination indexes. The analysis of the possible related factors ofHSPN by using linear correlation analysis.Results:1. Renal biopsy pathological grade: Renal biopsy pathologicalgrading indicated that adult Ⅱ were10cases (14.71%), grade Ⅲ51cases(75%), grade Ⅳ7cases (10.29%); Renal biopsy pathological grading of children Ⅱ were15cases (21.13%), grade Ⅲ47cases (66.20%), gradeⅣ9cases (12.68%).2. Pathological crescent, renal interstitial fibrosis and renalartery changes: Adults and children with crescent were50cases(73.53%) and40cases (56.34%), had significant differences, P <0.05.Adults and children with renal interstitial fibrosis were27cases (39.71%)and6cases (8.45%), there was significant difference, P <0.001. Adultsand children with renal arteriole was16cases (23.5%) and1cases(1.41%), there was significant difference, P <0.05.3. Correlation between pathological grading and laboratoryexamination: Pathological grading Ⅱ level in adult and children’s groups,serum creatinine, uric acid and blood eosinophils significantly increased,with significant difference, P <0.05; prothrombin time, platelet countdecreased, there was significant difference, P <0.05. Pathologicalgrading Ⅲ level, blood urea nitrogen, serum creatinine, blood uric acid,serum albumin, urine red blood cells, urine IgG, fibrinogen andeosinophils significantly increased, with significant difference, P <0.05;thrombin time, platelet count was significantly reduce, have significantdifference, P <0.05. Pathological grading Ⅳ level, blood urea nitrogen,creatinine, uric acid, blood eosinophils significantly increased, withsignificant difference, P <0.05. Adult pathological grade and serumcreatinine, urine A1microglobulin, urine IgG,24hour urinary protein,24hours urine albumin excretion was positively related, P <0.05; and negatively correlated with serum albumin, P <0.05. Children withpathological grading was positively correlated with24hour urinaryprotein,24hours urine albumin excretion, serum globulin, P <0.05; andnegatively correlated with serum albumin, P <0.05.4. Correlation between pathological renal interstitial fibrosis andlaboratory examination: Adults with and without renal interstitialfibrosis were compared between groups, serum creatinine, blood uric acid,urine protein, serum immunoglobulin and complement C3weresignificantly increased, with significant difference, P <0.05. Childrenwith renal interstitial fibrosis and no renal interstitial fibrosis comparedurea nitrogen, serum globulin protein, complement C3, C4, prothrombintime, fibrinogen are elevated, there was a significant difference, P <0.05.Urine protein, β2microglobulin in urine,24hour urinary protein,thrombin time, platelet count, addicted to eosinophilia decreased, therewas significant difference, P <0.05. Adults and children with renalinterstitial fibrosis were compared between groups, serum creatinineincreased significantly, prothrombin time decreased, there was significantdifference, P<0.05. Adult and children without renal interstitial fibrosisgroup test results, blood urea nitrogen, serum creatinine, blood uric acid,urine red blood cells, urine IgG, a1urine microglobulin,24hour urinaryprotein, fibrinogen and eosinophils were significantly increased, P<0.05;platelet count and thrombin time, there was significant difference,P<0.05. Conclusions:1. The pathological grade of the renal pathological grade of theallergic purpura nephritis in adults and children was grade Ⅲ.2. The pathological grade of renal pathological grade of allergicpurpura nephritis in adults and children was positively related to urineprotein and serum creatinine, and negatively correlated with serumalbumin.3. The changes of the glomerular crescent, renal interstitial fibrosis,renal artery changes and laboratory detection index were more seriousthan the adult and children with the same pathological grade as the samepathological grade as the same pathological grade.