关键词: 肾组织病理, 肾活检, 儿童, 流行病学

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To analyze the changes and epidemiological trend of renal biopsyproven children kidney diseases from a single center in the past eight years.
Ｍｅｔｈｏｄｏｌｏｇｙ：A retrospective analysis of 1 136 of renal biopsyproven cases in nephrology and rheumatology department of Shanghai Children′s Hospital from January 2010 to December 2017 was conducted. All the renal tissue specimens were examined by light microscopy,immunofluorescence and electron microscopy. Crosssectional analysis was carried out according to the same time sequence. The first stage (P1) was 561 cases from January 2010 to December 2013,and the second stage (P2) was from January 2014 to December 2017 (P2) (575 cases).
Ｒｅｓｕｌｔｓ：(1) The average age at renal biopsy in 1 136 children was 808±357 years (10 months to 18 years),and the ratio of male to female was 152∶1. The proportions of age 02,36,711 and 1218 were 607% (69 cases),2905% (330 cases),4595% (522 cases) and 1893% (215 cases) respectively. The proportion of renal biopsy patients in all hospitalized patients was 131% (1 136/8 652). (2) According to pathological classification,primary glomerular disease was the most important renal disease (7447%),of which minimal change disease(MCD,2648%) was the most common disease,followed by glomerular minor lesion (2530%),IgA nephropathy (IgAN,2423%),mesangial proliferative glomerulonephritis (1040%),focal segmental glomerulosclerosis (402%),IgM nephropathy (IgMN,331%) and membranous nephropathy (296%). In secondary renal disease (2227%),HenochSchnlein purpura nephritis (HSPN,7510%) and lupus nephritis (2174%) were the main pathological types. Hereditary kidney disease accounted for 290% of renal biopsies. The main pathological types were Alport syndrome (8182%) and thin basement membrane nephropathy (1515%). (3) Pathological spectrum changes:Compared with P1,the ratio of renal biopsy at 02 years in P2 was increased (P<005),the proportion of hereditary nephropathy increased (P<001),IgA nephropathy (P<001) and IgM nephropathy (P<001) increased,while the proportion of HSPN decreased significantly (P<001).
Ｃｏｎｃｌｕｓｉｏｎ：
Primary renal disease was still the main type of renal disease in children. The most common pathological types were MCD and IgAN. IgAN and IgMN had increased significantly in children in the last four years. HSPN and lupus nephritis were the main pathological types of secondary kidney diseases. HSPN had a downward trend.