Liu Feng, Wang Chenyu, Wang Rongzhen, Wang Wenge, Li Min
Institute of Pathology, Basic Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, China.
Department of Nephropathy, The First Hospital of Lanzhou University, Lanzhou, Gansu Province, China.
Open Med (Wars). 2018 Nov 27;13:597-604. doi: 10.1515/med-2018-0088. eCollection 2018.
To investigate the clinical pathology and prognosis & outcome of Henoch-Schonlein purpura nephritis (HSPN) with renal interstitial lesions.
All 148 patients were analyzed for clinical, renal pathological, and prognostic features. Patients with no, mild, and moderate- severe renal tubulo-interstitial lesions were included in group A, B and C, respectively.
The estimated glomerular filtration rate (eGFR) of group B was significantly lower than that of group A. The levels of serum creatinine and blood urea nitrogen in group C were significantly higher than those in groups A and B. Clinical type II was correlated with pathological types II and IIIa; pathological type IV and IIIb were correlated with clinical type VI and IV. There were significant differences in the level of red blood cells in urinary sediment, levels of urine occult blood and in the prognosis among the 3 groups.
Clinically, Type II is the most common cause; pathologically, Type IIIa is more common. The severity of renal tubulo-interstitial lesions is positively correlated with a decline in renal function and GFR. There is a correlation between the severity of renal tubulo-interstitial lesions and the severity of hematuria. Most patients with HSPN have a good prognosis.
探讨伴肾间质病变的过敏性紫癜性肾炎（HSPN）的临床病理及预后情况。
对148例患者的临床、肾脏病理及预后特征进行分析。无、轻度及中重度肾小管间质病变的患者分别纳入A组、B组和C组。
B组的估算肾小球滤过率（eGFR）显著低于A组。C组的血清肌酐和血尿素氮水平显著高于A组和B组。临床Ⅱ型与病理Ⅱ型和Ⅲa型相关；病理Ⅳ型和Ⅲb型与临床Ⅵ型和Ⅳ型相关。三组间尿沉渣红细胞水平、尿潜血水平及预后存在显著差异。
临床上，Ⅱ型是最常见病因；病理上，Ⅲa型更常见。肾小管间质病变的严重程度与肾功能及GFR下降呈正相关。肾小管间质病变严重程度与血尿严重程度之间存在相关性。大多数HSPN患者预后良好。
