The Retrospective Analysis Of Clinical And Pathological Features Of 371 Children With Henoch-schonlein Purpura Nephritis

Objective:To explore the relationship between clinical and pathological conditions of children with Henoch-schonlein purpura nephritis,by using the method of retrospective analysis,so that we could know it better,for the clinical diagnosis and treatment to provide better material support.Methods: 371 patients with purpura nephritis in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from 2012 to 2014 were selected as the subjects.Collecting the patient' clinical cases and kidney pathology reports,counting their general situations,clinical manifestations(including clinical classifications,symptoms,24 hours urinary protein levels,etc)and pathological conditions(including optical microscope and immunofluorescence examination).Using statistical methods to analyze the relationship between the clinical and pathological conditions.Results:1.The general situation:371 patients with HSPN,223 males and 148 females,the ratio of male to female was 1.61:1,the average age was(9.86±3.038),the main age of onset was 6~12 years old.2.HPSN clinical classification,the type with hematuria and proteinuria was the most.The second case was the nephrotic syndrome type,the case of simple hematuria and pure proteinuria was in the minority.Did not find the patients with acute nephritis,accelerated nephritis syndrome and chronic nephritis.The clinical manifestations associated with gastrointestinal symptoms of HSPN children more likely appeared massive proteinuria than the children without gastrointestinal symptoms(P<0.05);the clinical manifestations of children with HSPN in gross hematuria symptoms were more likely to have nephrotic syndrome than those with macroscopic haematuria(P<0.05).The principal syndromes of clinical classification of Chinese medicine was syndrome of stirring blood due to intense heat.The secondary syndrome was syndrome of blood stasis.3.Pathological conditions:Class II and Class III of pathological classification were the most.Immune fluorescence parting,the typeof simple Ig A was the most,then were the Ig A+Ig G type and Ig A+Ig M type,did not find the Ig A+Ig G+Ig M type.There was no significant relationship between complement C3,immunofluorescence classification and pathological grading(P>0.05).There was a correlation between renal tubular function classification and pathological grading(P<0.05).There were 96 cases without the crescent,93 cases with crescent content below 10%,89 cases with crescent content between 10% to 20%,49 cases with crescent content between20% to 30%,25 cases with crescent content between 30% to 40%,13 cases with crescent content between 40% to 50%,6 cases with crescent content above 50%.4.The pathological and clinical relationship:Correlation between the clinical classification and pathological classification(P<0.01);Correlation between the crescent content and the urine protein levels(P<0.01);No significant correlation between the clinical classification and the immunofluorescence classification.Conclusion:1.Macroscopic haematuria and digestive tract symptoms in clinical manifestation were the risk factors for the occurrence of a large amount of proteinuria.2.There was a certain parallel relationship between clinical classification and pathological classification.3.The content of crescent was related to the level of urinary protein.