目的 了解儿童肾小球疾病病理类型分布.方法 回顾性分析1987年2月至2012年2月间收治的3090例肾小球疾病患儿的肾活检病理资料.结果 在3090例患儿中,男女比为2.05:1;年龄 (9.5±4.1) 岁;原发性肾小球肾炎2 361例 (76.4%),继发性肾小球肾炎687例 (22.2%),遗传性肾病42例 (1.4%).原发性肾小球肾炎患儿病理分型依次为系膜增生44.7%,微小病变16.4%,毛细血管内增生14.7%,IgA肾病14.3%,轻微病变4.3%,局灶节段性肾小球硬化症3.4%,膜性肾病1.3%,膜增生性肾小球肾炎0.6%,新月体型肾炎0.3%.继发性肾小球肾炎患儿病理分型依次为紫癜性肾炎78.4%,乙肝相关性肾炎11.4%,狼疮性肾炎10.2%.结论 儿童肾小球疾病以原发性肾小球疾病最为常见,男性多见,儿童原发肾小球肾炎最常见为系膜增生,儿童继发性肾小球肾炎最常见为紫癜性肾炎.%Objective To explore pathological features of glomerular diseases in children. Methods The pathological data of 3090 children with biopsy-proven glomerular diseases from February 1987 to February 2012 were analyzed retrospectively. Results The boy to girl ratio was 2.05: 1 in 3090 children and the average age was (9.5±4.1) years. the clinical typing included primary glomerular disease 2 351 (76.4%), secondary giomeralar disease 587 (22.2%) and inherited kidney disease 42 (1.4%). Among the children with primary glomerular disease, mesangial proliferative glomerulonephritis was the most frequent type (44.7%). followed by minimal change giomcrulopathy (16.4%). endocapillary proliferation glomerulonephritis (14.7%). IgA nephropaihy (14.3%), glomerular minor lesion (4.3%)), focal segmenlal glomerulosclerosis (3.4%), membranous glomerulopathy (1.3%), membranoproiiferative giomeruionephritis (0.6%) and crescentic glomerulonephritis (0.3%). Among the children with secondary glomerular disease, Henoch-Schonlein purpura nephritis was the most frequent type (78.4%), followed by hepatitis B virus-associated glomerulonephritis (11.4%) and lupus nepliritis (10.2%). Conclusions Primary glomerular disease was common in childhood glomerular diseases with a male predominance. The main pathological presentation in primary glomerular disease was mesangial proliferative glomerulonephritis. For secondary glomerular disease, Henoch-Schonlein purpura nephritis was the most frequent type.
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