目的：分析小儿紫癜性肾炎的临床特点。方法：回顾分析两院儿科最近8年收治的小儿紫癜性肾炎180例的临床表现、实验室检查结果，治疗和预后等方面的资料。结果(1)临床以血尿蛋白尿型最多见(61/180)，其次为急性肾炎型(36/180)、肾病综合征型(31/180)和单纯血尿或蛋白尿型(25/180)。(2)重症病儿短期使用激素可改善肾脏损害。(3)所有病例均有必要长期随访。结论：小儿紫癜性肾炎绝大多数预后良好，但病情反复不愈者可发展为终末期肾脏损害，故需要长期随访。
【摘要】 目的 制备小鼠肾炎模型并观察双氢青蒿素（dihydroartemisinine，DHA）对模型小鼠细胞因子肿瘤坏死因子-α（tunor necrosis factor，TNF-α）和白细胞介素-6（inter leukin-6，IL-6）的影响以及小鼠肾脏的病理变化。 方法 取雄性昆明种小鼠120只， 随机分为正常对照组、脂多糖（lipopolysaccharides，LPS）组、LPS+肾匀浆组及DHA治疗组；分别于12、24、48 h取血，酶联免疫吸附试验检测血清中TNF-α和IL-6的含量，苏木精-伊红染色法观察小鼠肾脏的病理变化。 结果 造模48 h LPS+肾匀浆组小鼠肾小球出现炎性细胞浸润，而正常对照组未见异常；LPS组及 DHA治疗组仅有轻微的病理改变。LPS刺激使小鼠血清TNF-α和IL-6含量高于正常水平（Plt;0.01），但有随时间不断下降的趋势；LPS+肾匀浆组较正常对照组TNF-α和IL-6含量升高（Plt;0.01）；DHA可显著下调模型小鼠血清TNF-α的水平（Plt;0.01），但对IL-6的影响相对较小（Pgt;0.05）。 结论 运用改良的造模方法LPS+肾匀浆建立肾炎模型效果良好；DHA可以调节模型小鼠炎症因子TNF-α和IL-6的释放，具有一定的改善模型小鼠肾炎症状的作用。【Abstract】 Objective To establish mice nephritis models, detect the serum level changes of cytokines tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) in the model mice treated by Dihydroartemisinin (DHA), and observe the physiological changes of the mice kidneys. Methods One hundred and twenty male Kunming mice were randomly divided into 4 groups: control group, lipopolysaccharides (LPS) group, LPS plus kidney homogenate group, and DHA treated group. The level of cytokines TNF-α and IL-6 in the serum were detected by enzyme-linked immunoabsordent assey at hour 12, 24, and 48, respectively. Pathological changes were observed by hematoxylin: eosin staining. Results At the time hour 48 after the establishment of the model, inflammatory cell infiltration was observed in the glomerulus of the LPS plus kidney homogenate group, but no abnormality was found in the control group. There were only slight pathological changes in mice models of the LPS group and the DHA treated group. The serum level of TNF-α and IL-6 increased remarkably after the treatment of LPS (Plt;0.01), but declined as time went by. The level of TNF-α and IL-6 increased significantly in LPS plus kidney homogenate group compared with the control group (Plt;0.01). DHA could significantly decrease the TNF-α level in the serum (Plt;0.01), but had a low influence on IL-6 (Pgt;0.05). Conclusion The modified LPS plus kidney homogenate has a good result in model establishing. DHA can regulate the release of TNF-α and IL-6 in the model mice, and may have certain good effects on ameliorating the nephritis pathological changes.
【摘要】 目的 发现提示早期Ⅴ型狼疮性肾炎（lupus nephritis，LN）的指标。 方法 2004年 1月-2009年11月24例经肾活检诊断为Ⅴ型LN患者，与同期50例膜性肾病伴抗核抗体（antinuclear antibody，ANA）阳性患者、50例膜性肾病ANA阴性患者，以及13例膜性肾病ANA阳性且肾组织荧光为“满堂亮”患者的一般资料、肾病表现、肾脏病理以及实验室指标进行比较。 结果 Ⅴ型LN与膜性肾病ANA阴性的患者相比，两组的性别、起病年龄、血红蛋白、补体水平、内皮和系膜增殖的比例等有明显差异。膜性肾病ANA阳性患者的临床和病理表现更接近于ANA阴性的膜性肾病，但其性别比仍以女性居多。而膜性肾病ANA阳性伴“满堂亮”的患者在性别、肾病表现、血红蛋白、补体水平等方面与Ⅴ型LN更为接近。 结论 膜性肾病ANA阳性患者具有异质性，其中肾脏病理表现为“满堂亮”的患者可能系早期Ⅴ型LN。【Abstract】 Objective To find out the clinical and pathological characteristics of early pure class Ⅴ lupus nephritis (LN). Methods A total of 24 patients with pure class Ⅴ LN diagnosed between January 2004 and November 2009 were included, and were compared with 50 antinuclear antibody (ANA)-positive patients with membranous nephropathy (MN) and 50 ANA-negative patients with MN. The clinical and pathological characteristics, laboratory test results were compared between the two groups. Then, 13 patients with "full house" fluorescence in renal biopsy specimens were chosen from the group of ANA-positive membranous nephropathy, whose clinical characteristics and laboratory test were compared with class Ⅴ LN patients. Results There were significant differences in sex ratio, age, positive rate of hepatitis B surface antigen (HBsAg), levels of hemoglobin, white blood cell, platelet,complement, endothelial and mesangial proliferation between class Ⅴ LN and ANA-negative MN group. However, the sex ratio, levels of white blood cell, platelet were similar between class Ⅴ LN and ANA-positive MN group. The renal biopsy specimens in patients with ANA-positive MN with "full house" fluorescence were similar with those in the patients with class Ⅴ LN in sex ratio, renal injury, hemoglobin and complement and the positive rate of hepatitis B surface antigen. Conclusion The demographic information and clinical manifestations in patients with class Ⅴ LN were similar to those in patients with ANA positive MN, especially in the patients wiht ANA-positive MN with "full house" fluorescence in renal biopsy specimens.
purpose To study the visual electrophysiological changes in patients with chronic glomerulonephritis. Methods The visual evoked potentials(VEP) and electroretinogram(ERG) of 26 subjects with chronic glomerulonephritis in 51 eyes were recorded. Results Ours studies showed the patients with chronic glomerulonephritis had pathologic visual electrophysiologic abnormalities.The N 75 peak latency,b wave peak latency O 1 peak latency and total amplitude of OPs in chronic glomerulonephritis patients without fundus sign showed remarkable difference. Conclusion These changes suggested visual electrophysiological examination may be valuable in early diagnosis of retinal disfunction in patients with chronic glomerulonephritis. (Chin J Ocul Fundus Dis,1998,14:162-164)