Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
Int Urol Nephrol. 2010 Dec;42(4):1023-9. doi: 10.1007/s11255-009-9701-3. Epub 2010 Jan 10.
Recently, there have been a few reports on the decrease in the incidence of severe Henoch-Schönlein purpura nephritis (HSPN) in Japan. To evaluate the incidence and the severity of HSPN, we examined the epidemiology and clinical manifestations of HSPN in Fukushima Prefecture over a 22-year period.
We enrolled 61 patients (Group 1) diagnosed with HSPN between 1987 and 1997 and a further 59 patients (Group 2) diagnosed with HSPN between 1998 and 2008. Epidemiology, clinical features, laboratory data, pathological findings, treatment and outcome were retrospectively compared between the two groups.
The mean number of patients per 100,000 children per year was 3.5 ± 1.2 in Group 1 and 3.6 ± 0.8 in Group 2. The clinical manifestations and laboratory findings at onset were comparable between Groups 1 and 2. Pathological findings in Group 1 and Group 2 were classified as ISKDC grade IIIa in 16 (26%) and 14 cases (24%), grade IIIb in 26 (43%) and 27 cases (46%), grade IV in 5 (8%) and 6 cases (10%)), grade V in 1 (2%) and 5 cases (8%), and grade VI in 2 (3%) and 2 cases (3%), respectively. There were no inter-group differences in ISKDC classification or rate of crescentic formation.
Our findings suggest that the incidence of HSPN and the severity of HSPN in patients between 1987 and 1997 were similar to those in patients between 1998 and 2008 and that the number of patients with severe HSPN has not decreased.
最近，有一些关于日本儿童过敏性紫癜性肾炎（HSPN）发病率下降的报道。为了评估 HSPN 的发病率和严重程度，我们对福岛县 22 年来 HSPN 的流行病学和临床表现进行了研究。
我们纳入了 1987 年至 1997 年间诊断为 HSPN 的 61 例患者（第 1 组）和 1998 年至 2008 年间诊断为 HSPN 的 59 例患者（第 2 组）。回顾性比较了两组之间的流行病学、临床特征、实验室数据、病理发现、治疗和结局。
第 1 组和第 2 组每年每 10 万儿童的平均患者数分别为 3.5 ± 1.2 和 3.6 ± 0.8。第 1 组和第 2 组的发病时临床表现和实验室检查结果相似。第 1 组和第 2 组的病理发现分别为 ISKDC 分级 IIIa 型 16 例（26%）和 14 例（24%），IIIb 型 26 例（43%）和 27 例（46%），IV 型 5 例（8%）和 6 例（10%），V 型 1 例（2%）和 5 例（8%），VI 型 2 例（3%）和 2 例（3%）。两组间 ISKDC 分级或新月体形成率无差异。
我们的研究结果表明，1987 年至 1997 年期间 HSPN 的发病率和严重程度与 1998 年至 2008 年期间相似，且严重 HSPN 的患者数量并未减少。
