目的：探讨过敏性紫癜肾炎(HSPN)患儿临床与病理特点。方法选择2009年4月至2013年4月HSPN患儿89例，回顾性分析其临床及病理资料。结果多数HSPN发生于紫癜病程2个月内，89例患儿的临床分型以血尿和蛋白尿型(41.6%)、肾病综合征型(27.0%)、孤立性蛋白尿型(21.3%)多见，而三者的病理分级均以Ⅲ级多见，分别占67.6%、70.8%、73.7%。不同临床分型紫癜肾患儿病理分级分布的差异有统计学意义(H=26.88，P=0.000)。21例合并消化道出血与68例无消化道出血患儿的病理分级差异有统计学意义(Z=2.00，P=0.046)，有消化道出血患儿的病理分级多为Ⅲ级和Ⅳ级，而无消化道出血患儿多为Ⅱ级和Ⅲ级。免疫复合物分型以IgA+IgM沉积最多(40.45%)，不同免疫复合物分型的病理分级分布差异无统计学意义(P>0.05)。结论 HSPN患儿临床分型与病理分级相关，病理分级以Ⅱ和Ⅲ级多见，合并消化道出血者病理分级较重。%Objective To analyze the relationship between clinical and pathological features in children with Henoche-Schönelin purpura nephritis (HSPN). Methods Clinical and pathological data of 89 children with HSPN from April 2009 to April 2013 in our hospital were retrospectively analyzed. Results A majority of patients (94.83%) suffered nephritis within two month after purpura. Clinically, hematuria and proteinuria (41.6%), nephrotic syndrome (27.0%), and isolated protein-uria (21.3%) are the most common type in children with HSPN. The majority of pathological changes of these three types HSPN are gradeⅢ, which accounts for 67.6%, 70.8%, and 73.7%, respectively. The clinical manifestations are closely associated with pathologic classiifcation (H=26.88, P=0.000). IgA plus IgM deposit was the most common type (40.45%) in histological and immunopathologic changes.There was no statistical difference between the pathologic classification and immunopathologic types. Gastrointestinal bleeding was associated with pathologic classiifcation. Conclusions The pathological changes of HPSN patients are mainly of gradesⅡandⅢ, and the clinical manifestations, gastrointestinal bleeding in particular, are closely associated with pathological classiifcation.
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