儿童原发性肾病综合征微小病变型合并小管间质损伤的病理及临床分析

Pathological and clinical analysis of minimal change primary nephritic syndrome with tubulointerstitial lesions in children

摘要:

目的：探讨儿童微小病变型肾病综合征合并小管间质损伤的临床与病理特点。方法：回顾性分析148例微小病变型肾病（minimal change nephrotic syndrome，MCN）患儿的临床与病理资料，比较MCN合并肾小管间质损伤（tubular interstitiallesion，TIL）的临床与病理特点。结果：小管间质损伤共28例，占比18.9%；小管间质损伤病理改变类型以炎症细胞浸润及小管扩张为主；TIL组患儿病情较Non-TIL组更重，表现为血尿、蛋白排泄增多、肾功能不全及小管功能下降，TIL的发生与肾功能损害密切相关；MCN转归情况与小管间质损伤无明显相关（P＞0.05）。结论：随着小管间质损伤的发生，MCN患儿病情加重，小管间质损伤可作为影响MCN进展的重要因素。

Abstract:

Objective：To investigate clinical and pathological characteristics of minimal change primary nephrotic syndrome（MCN） with tubulointerstitial lesions（TIL） in children. Methods：Pathological and clinical materials of 148 patients with MCN were retrospec－tively analyzed，and clinical and pathological characteristics of MCN with TIL were compared. Results：A total of 28 patients had TIL，accounting for 18.9%；the main pathological changes of TIL were inflammatory cell infiltration and tubule dilatation. The condition of children in the TIL group were more severe than that in the non-TIL group，with manifestations such as hematuria，increased protein excretion，renal inadequacy，and significantly impaired tubule function，indicating that renal function damage was closely related to development of TIL. MCN outcome was not obviously associated with TIL（P>0.05）. Conclusion：With the occurrence of TIL，the con－dition of children with MCN is aggravated，indicating that TIL may be an important factor influencing the progression of MCN.