IgA肾病伴毛细血管袢坏死的临床病理分析  

The Clinicopathological Study of Idiopathic IgA Nephropathy with Segmental Necrotizing Lesions of the Capillary Wall

作　　者：马纪林[1] 陶筱娟[1] 陈立红[2] 方鲁[1] 沈福娣[1] 张雯[1] 

机构地区：[1]浙江省中西医结合医院肾内科,杭州310003 [2]浙江省中西医结合医院病理科,杭州310003

出　　处：《中国中西医结合肾病杂志》2004年第11期637-639,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：浙江省中医药管理局基金资助项目 (No .2 0 0 3Y0 17)

摘　　要：目的 :分析IgA肾病伴毛细血管袢坏死 (NecrotizingIgAnephropathy ,NIgAN )患者的临床和病理特点。方法 :对 15例NIgAN患者 ,进行回顾性分析其临床及肾脏病理参数 ,并和不伴毛细血管袢坏死的IgA肾病 (Non-NIgAN)患者进行比较。 结果 :两组患者在临床指标 ,如蛋白尿程度、高血压发生率、肾功能水平之间无统计学差异 ;在肾活检指标中 ,NIgAN组与Non -NIgAN组相比 ,仅在新月体形成比例有统计学差异 (P <0 .0 1)。 结论 :IgA肾病伴毛细血管袢坏死在总体IgA肾病中并不少见 ,临床表现无特殊 。Objective:To analyze the clinical and pathological features of idiopathic IgA nephropathy with segmental necrotizing lesions of the capillary wall.Methods:Fifteen hospitalized IgAN patients with segmental necrotizing lesions of the capillary wall in our division were reviewed retrospectively.The clinicomorphologic features were compared with those of a control group of IgAN patients who lacked active segmental necrosis.Results:Patients with the necrotic variant showed more marked crescent formation ( P <0.01), No significant difference was found in clinical findings such as amount of proteinuria, level of blood urine nitrogen and frequency of hypertension.Conclusion:IgA nephropathy with segmental necrotizing lesions of the capillary wall,were found in about 5% of patients with idiopathic IgAN. Clinical findings were not different from those of the patients with IgAN. Therefore, renal biopsy should be more important in the patients.

关 键 词：IGA肾病 坏死 毛细血管 患者 临床病理分析 肾活检 临床指标 肾脏病理 新月体形成 蛋白尿 

分 类 号：R692.3[医药卫生—泌尿科学]