影像医学在儿童IgA血管炎肾炎诊疗中的临床价值
The Clinical Value of Medical Imaging in the Diagnosis and Treatment of IgA Vasculitis Nephritis in Children
DOI: 10.12677/acm.2026.161289, PDF,   
作者: 游思勤, 王 荞*:重庆医科大学附属儿童医院超声医学科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿童代谢与炎症性疾病重庆市重点实验室,重庆
关键词: IgA血管炎肾炎过敏性紫癜性肾炎儿科影像医学综述IgA Vasculitis Nephritis Henoch-Schönlein Purpura Nephritis Pediatrics Medical Imaging Review
摘要: IgA血管炎是儿童常见的血管变态反应性疾病,该病的远期预后取决于肾脏的受累程度,因此IgA血管炎肾炎的长期随访十分必要。本文叙述了IgA血管炎的发病机制和临床诊疗策略,回顾了影像医学技术在儿童IgA血管炎肾炎诊疗中的临床价值,旨在深入了解该领域的研究进展,为临床管理IgA血管炎肾炎提供新思路,以改善患者远期预后。
Abstract: IgA vasculitis is a common vascular allergic disease in children. The long-term prognosis of this disease depends on the degree of renal involvement. Therefore, long-term follow-up of IgA vasculitis nephritis is very necessary. This article describes the pathogenesis and clinical diagnosis and treatment strategies of IgA vasculitis, and reviews the clinical value of medical imaging technology in the diagnosis and treatment of IgA vasculitis nephritis in children. It aims to deeply understand the research progress in this field, provide new ideas for the clinical management of IgA vasculitis nephritis, and improve the long-term prognosis of patients.
文章引用:游思勤, 王荞. 影像医学在儿童IgA血管炎肾炎诊疗中的临床价值[J]. 临床医学进展, 2026, 16(1): 2311-2317. https://doi.org/10.12677/acm.2026.161289

参考文献

[1] Gardner-Medwin, J.M., Dolezalova, P., Cummins, C. and Southwood, T.R. (2002) Incidence of Henoch-Schonlein Purpura, Kawasaki Disease, and Rare Vasculitides in Children of Different Ethnic Origins. The Lancet, 360, 1197-1202. [Google Scholar] [CrossRef] [PubMed]
[2] Buscatti, I.M., Casella, B.B., Aikawa, N.E., Watanabe, A., Farhat, S.C.L., Campos, L.M.A., et al. (2018) Henoch-Schönlein Purpura Nephritis: Initial Risk Factors and Outcomes in a Latin American Tertiary Center. Clinical Rheumatology, 37, 1319-1324. [Google Scholar] [CrossRef] [PubMed]
[3] Carucci, N., La Barbera, G., Peruzzi, L., La Mazza, A., Silipigni, L., Alibrandi, A., et al. (2022) Time of Onset and Risk Factors of Renal Involvement in Children with Henoch-Schönlein Purpura: Retrospective Study. Children, 9, Article No. 1394. [Google Scholar] [CrossRef] [PubMed]
[4] Ekinci, R.M.K., Balci, S., Sari Gokay, S., Yilmaz, H.L., Dogruel, D., Altintas, D.U., et al. (2019) Do Practical Laboratory Indices Predict the Outcomes of Children with Henoch-Schönlein Purpura? Postgraduate Medicine, 131, 295-298. [Google Scholar] [CrossRef] [PubMed]
[5] Launay, P., Grossetête, B., Arcos-Fajardo, M., Gaudin, E., Torres, S.P., Beaudoin, L., et al. (1999) Fcα Receptor (cd89) Mediates the Development of Immunoglobulin A (IgA) Nephropathy (Berger’s Disease): Evidence for Pathogenic Soluble Receptor-IgA Complexes in Patients and CD89 Transgenic Mice. The Journal of Experimental Medicine, 191, 1999-2010. [Google Scholar] [CrossRef] [PubMed]
[6] 邹万忠. 肾活检病理学[M]. 第4版. 北京: 北京大学医学出版社, 2017: 145-147.
[7] Bennett, W.M. and Kincaid-Smith, P. (1983) Macroscopic Hematuria in Mesangial Iga Nephropathy: Correlation with Glomerular Crescents and Renal Dysfunction. Kidney International, 23, 393-400. [Google Scholar] [CrossRef] [PubMed]
[8] Foster, B.J., Bernard, C., Drummond, K.N. and Sharma, A.K. (2000) Effective Therapy for Severe Henoch-Schonlein Purpura Nephritis with Prednisone and Azathioprine: A Clinical and Histopathologic Study. The Journal of Pediatrics, 136, 370-375. [Google Scholar] [CrossRef] [PubMed]
[9] Barbour, S.J., Coppo, R., Er, L., Pillebout, E., Russo, M.L., Alpers, C.E., et al. (2024) Histologic and Clinical Factors Associated with Kidney Outcomes in Iga Vasculitis Nephritis. Clinical Journal of the American Society of Nephrology, 19, 438-451. [Google Scholar] [CrossRef] [PubMed]
[10] Goldstein, A.R., White, R.H.R., Akuse, R. and Chantler, C. (1992) Long-Term Follow-Up of Childhood Henoch-Schönlein Nephritis. The Lancet, 339, 280-282. [Google Scholar] [CrossRef] [PubMed]
[11] Ronkainen, J., Nuutinen, M. and Koskimies, O. (2002) The Adult Kidney 24 Years after Childhood Henoch-Schönlein Purpura: A Retrospective Cohort Study. The Lancet, 360, 666-670. [Google Scholar] [CrossRef] [PubMed]
[12] Xu, K., Zhang, L., Ding, J., Wang, S., Su, B., Xiao, H., et al. (2017) Value of the Oxford Classification of Iga Nephropathy in Children with Henoch-Schönlein Purpura Nephritis. Journal of Nephrology, 31, 279-286. [Google Scholar] [CrossRef] [PubMed]
[13] Kim, C.H., Lim, B.J., Bae, Y.S., et al. (2014) Using the Oxford Classification of IgA Nephropathy to Predict Long-Term Outcomes of Henoch-Schönlein Purpura Nephritis in Adults. Modern Pathology, 27, 972-982. [Google Scholar] [CrossRef] [PubMed]
[14] Zhang, J. (2024) Application Value of Real-Time Shear Wave Elastography for Quantitative Evaluation of Chronic Kidney Disease in Pediatric Patients. American Journal of Translational Research, 16, 5595-5604. [Google Scholar] [CrossRef] [PubMed]
[15] Lakshmana, S., Koteshwar, P. and Kamath, T. (2024) Value of Shear Wave Elastography in the Evaluation of Chronic Kidney Disease. International Journal of Nephrology and Renovascular Disease, 17, 307-317. [Google Scholar] [CrossRef] [PubMed]
[16] Zhang, T., Yan, J., Wu, J., Yang, W., Zhang, S., Xia, J., et al. (2023) Shear Wave Elastography Parameters Adds Prognostic Value to Adverse Outcome in Kidney Transplantation Recipients. Renal Failure, 45, Article ID: 2235015. [Google Scholar] [CrossRef] [PubMed]
[17] Liu, Q. and Wang, Z. (2021) Diagnostic Value of Real-Time Shear Wave Elastography in Children with Chronic Kidney Disease. Clinical Hemorheology and Microcirculation, 77, 287-293. [Google Scholar] [CrossRef] [PubMed]
[18] 崔晓颖, 占小梅, 徐茂晟, 等. 剪切波弹性成像在过敏性紫癜儿童肾脏中的应用[J]. 医学研究杂志, 2023, 52(11): 133-136+141.
[19] 南彩玲, 张炜阳, 姚亚宁, 等. 声触诊组织定量技术对儿童过敏性紫癜肾炎肾脏纤维化的评估[J]. 兰州大学学报(医学版), 2018, 44(5): 63-66.
[20] 柳悦. 声触诊组织定量技术在儿童紫癜性肾炎中的临床应用研究[D]: [硕士学位论文]. 河南: 郑州大学, 2018.
[21] 李雪娇, 高虹, 郭峻梅, 等. 实时剪切波弹性成像在儿童过敏性紫癜肾炎诊断中的应用价值[J]. 医学综述, 2020, 26(13): 2659-2663.
[22] Shi, L., Sun, J., Yuan, L., Wang, X., Li, W., Cheng, C., et al. (2023) Diagnostic Performance of Renal Cortical Elasticity by Supersonic Shear Wave Imaging in Pediatric Glomerular Disease. European Journal of Radiology, 168, Article ID: 111113. [Google Scholar] [CrossRef] [PubMed]
[23] 骈林萍, 吴佳佳, 张玲莉, 等. 声辐射力脉冲成像对紫癜性肾炎的定量研究[J]. 中国医学影像学杂志, 2016, 24(8): 604-607.
[24] Zhang, H., Liu, Q., Chen, Z., Yao, X., Ling, C., Lei, L., et al. (2022) Contrast-Enhanced Ultrasonography for Assessing Histopathology in Pediatric Immunoglobulin a Nephropathy and Henoch-Schönlein Purpura Nephritis. Pediatric Radiology, 52, 2575-2583. [Google Scholar] [CrossRef] [PubMed]
[25] Chen, J., Wen, Z., Yang, X., Jia, J., Zhang, X., Pian, L., et al. (2023) Ultrasound-Based Radiomics for the Classification of Henoch-Schönlein Purpura Nephritis in Children. Ultrasonic Imaging, 46, 110-120. [Google Scholar] [CrossRef] [PubMed]
[26] 刘晓杰, 冯柳. 99mTc-DTPA肾动态显像与过敏性紫癜性肾炎新月体形成率的相关性研究[J]. 中国现代医生, 2023, 61(24): 30-33.
[27] Nishino, T., Takahashi, K., Ono, S. and Mimaki, M. (2022) Fluctuation of R2* Values in Blood Oxygenation Level-Dependent MRI during Acute and Remission Phases of IgA Vasculitis with Nephritis in Children. Japanese Journal of Radiology, 40, 840-846. [Google Scholar] [CrossRef] [PubMed]