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本文报告36例小儿难治性肾病,其中单纯型对激素的反应可为激素耐药、激素依赖或频繁复发,病理上表现为微小病变、系膜增殖性肾小球肾炎和局灶节段性肾小球硬化;肾炎型则主要为激素耐药,病理上表现为除微小病变外的其它病理类型。但这两种类型在是否伴发小管间质改变上没有差异。从病理上来看,本组病儿86%为非微小病变型,以系膜增殖性肾小球肾炎为多,局灶节段性肾小球硬化次之。故对这类病儿尽早肾活检有助于明确诊断、指导治疗及判断预后。
This article reports 36 cases of pediatric refractory nephropathy, in which the simple type of response to hormones may be hormone-resistant, hormone-dependent or frequent recurrence, the pathological manifestations of minimal change, mesangial proliferative glomerulonephritis and focal segmental Glomerular sclerosis; nephritis is mainly hormone-resistant, pathological manifestations of other pathological types except for minor lesions. However, there is no difference between the two types in whether there is concomitant tubulointerstitial changes. From the pathological point of view, 86% of the children in this group of non-minimal lesions, mesangial proliferative glomerulonephritis as focal, focal segmental glomerulosclerosis followed. So as soon as possible for these patients kidney biopsy helps to confirm the diagnosis, treatment and prognosis.