Clinical And Pathological Analysis Of 185 Children With Purpura Nephritis

Object:This article retrospectively analyzed the clinical characteristics and laboratory indexes of children with Henoch-Schonlein purpura nephritis,explained the clinical relationship of allergic purpura nephritis,laboratory indicators and purpura nephritis classification,explored the factors affecting the duration of urinary protein and provide a basis for clinical diagnosis,treatment and prognosis of children with allergic purpura nephritis.Methods:From April 2017 to March 2019,185 cases children diagnosed as allergic purpura nephritis enrolled into the Soochow university affiliated children's hospital were collected as our study.The clinical information(the general situation,clinical data,pathological classification,treatment,etc.)and kidney disease inspection indicators(routine urine,urine protein,24h urine protein,renal function,B-ultrasound and renal pathology)were retrospectively collected and analyzed.All children with purple epilepsy nephritis were classified according to clinical type and urinary protein level.The laboratory indexes of children with different types of purple epilepsy nephritis were analyzed and compared.The follow-up was confirmed by renal biopsy and accompanied by proteinuria.The duration of urinary protein and the factors affecting the duration of urinary protein in children with purpuric nephritis were investigated.Results:1.Among the 185 cases of children with purpura nephritis,106 males and 79 females,with a male-female ratio of 1.34:1.The mean age of onset was(7.6±0.54)years.The duration was 10?15 days,with median of 14 days.142 cases(77%)were recurrent rash,107 cases(58%)were gastrointestinal bleeding occurred,118 cases(64%)joint pain,77 cases(42%)abnormal urine test within 1 week after onset,and 95 cases(51%)abnormal urine test results between 1 week and 1 month after onset.The clinical classification results showed that there were 41 cases(22.2%)isolated hematuria,39 cases(21.1%)isolated proteinuria 84 cases(45.4%)hematuria and proteinuria,17 cases(9.2%)nephrotic syndrome,3 cases(1.6%)acute nephritis,1 case(0.5%)chronic nephritis,none acute nephritis.The duration of the type of isolated proteinuria was the shortest,the age of onset of isolated hematuria and isolated proteinuria was the largest.2.Urine protein characterization is a better screening index for Henoch-Schonlein purpura nephritis.The level of urine protein was significantly correlated with hematuria?renal pathological changes?renal color ultrasonic echo of renal cortex and serum cystatin(cys-c),while had no correlation with serum creatinine(Cr)and urea nitrogen(BUN).3.According to the order of isolated proteinuria,hematuria and proteinuria,acute nephritis,nephrotic syndrome,chronic nephritis,the duration of urinary protein is prolonged gradually,P<0.05?According to the order of glomerular pathological grade?,?,? and ?,the duration of urine protein gradually prolonged(P<0.001).Conclusions:1.In this study,93%of renal damage occurred within 1 month after onset.The isolated hematuria and isolated proteinuria were the most common clinical classifications.2.The 24-hour urine protein ration in children with Henoch-Schonlein purpura nephritis was positively correlated with the grade of glomerular pathology.3.The duration of urine protein in children with Henoch-Schonlein purpura nephritis was correlated with clinical type and pathological grade.