儿童C3肾小球肾炎6例临床与病理分析

发布时间：2018-07-02 20:46

本文选题：儿童 + C肾小球肾炎　；参考：《中国实用儿科杂志》2017年05期

【摘要】：目的分析6例儿童C3肾小球肾炎的临床表现、病理特征及治疗反应,旨在提高儿科医生对此病的认识和处理。方法对2010年9月至2016年6月在吉林大学第一医院小儿肾病科确诊为C3肾小球肾炎且有完整临床资料的6例患儿的临床表现、病理改变、疗效及预后进行回顾性分析。结果(1)临床表现及实验室检查:以血尿为首发症状2例,以血尿和蛋白尿为首发症状4例;其中表现为肾炎综合征3例,肾病综合征1例;6例患儿补体C3均降低;补体C4均正常;(2)病理特点:6例患儿免疫荧光均可见补体C3强阳性沉积;光镜下表现为系膜增生性肾小球肾炎5例,表现为毛细血管内增生性肾小球肾炎1例;电镜下3例可见电子致密物沉积,3例未见电子致密物沉积;(3)治疗及预后;均予肾炎常规治疗,2例有新月体形成者加用糖皮质激素治疗。随访6~42个月,预后较好。结论本组C3肾小球肾炎患儿以血尿和(或)蛋白尿为主要表现,免疫荧光见C3强阳性沉积,光镜表现多以系膜增生性肾小球肾炎为主,电镜可表现为电子致密物沉积,短期预后较好。
[Abstract]:Objective to analyze the clinical manifestations, pathological features and therapeutic responses of 6 children with C3 glomerulonephritis, in order to improve the understanding and treatment of the disease by pediatricians. Methods from September 2010 to June 2016, 6 cases of C3 glomerulonephritis diagnosed in the Department of Pediatric Kidney, first Hospital of Jilin University, with complete clinical data, were retrospectively analyzed. Results (1) Clinical manifestation and laboratory examination: hematuria was the first symptom in 2 cases and hematuria and proteinuria as the first symptom in 4 cases. Complement C4 was normal, (2) the positive deposition of complement C3 was observed in all of the 6 cases of children with microscopical pathological features, 5 cases with Mesangial proliferative glomerulonephritis and 1 case with endocapillary proliferative glomerulonephritis under light microscope. Electron microscopic examination showed that 3 cases had no electron dense matter deposition; (3) treatment and prognosis; 2 cases with crescent formation were treated with glucocorticoid plus glucocorticoid. Follow-up for 6 ~ 42 months showed a good prognosis. Conclusion in this group of children with C3 glomerulonephritis, hematuria and / or proteinuria are the main manifestation, immunofluorescence is strong positive deposition of C3, light microscope is mainly Mesangial proliferative glomerulonephritis, electron microscope can show electron dense deposition. The short-term prognosis is good.
【作者单位】：吉林大学第一医院小儿肾病科;
【分类号】：R726.9

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