表现为急性肾衰竭的IgA肾病11例临床与病理分析  

The Clinical and Pathological Character of Acute Renal Failure in Patients with IgA Nephropathy

作　　者：周建中[1] 姜傥[1] 关伟明[1] 董秀清[1] 黄锋先[1] 

机构地区：[1]中山大学附属第一医院肾病研究所,广州510080

出　　处：《中国中西医结合肾病杂志》2005年第6期339-341,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然科学基金资助项目 (No .3 0 3 70 661)

摘　　要：目的:探讨IgA肾病并发急性肾衰竭(ARF)的临床与病理特点。方法:回顾分析11例IgA肾病并发ARF的临床与病理资料。结果:(1)本组11例IgA肾病患者并发ARF ,占我院同期IgA肾病的1.2 8% (11/86 0 ) ;(2 )本组患者7例患者以浮肿、少尿为首发症状,3例以反复肉眼血尿为主诉、1例以恶性高血压为主要症状,6例患者蛋白尿≥2 .0g/d ;(3)肾活检示系膜增生性肾炎7例、新月体肾炎1例、增生硬化性肾炎伴新月体形成1例,余2例为IgA肾病的基础上伴发急性肾小管间质性肾炎。(4)本组资料中8例患者行激素加MP/CTX冲击治疗,4例予以单纯对症处理;8例肾功能恢复正常,1例肾功能部分缓解,2例患者肾功能进展行维持性透析治疗,总有效率为81.8%。结论:IgA肾病并发ARF发生率不低,病理可表现为多种病理类型,病理改变轻,预后好,多数患者肾功能可以恢复正常。Objective:investigate the clinical and pathological feature of IgA nephropathy complicated with acute renal failure (ARF).Methods:11 IgA patients presenting with ARF were recruited in our study. The clinical and pathological data were analysized retrospectively.Results:(1)the incidence of IgA presented with ARF was 1.28%(11/860)in our group;(2)Most patients presented with oedema, oliourine (7/11);3 presented gross haematuria and 1 evil hypertension; 6 patients with heavy proteinuria ≥2.0 g/d;(3)mesangioproliferative glomerulonephritis being the most common (7 patients,63.6%) in our group, followed by crescentic glomerulonephritis and mesangioproliferative and sclerosis glomerulonephritis (1 patients each ).IgAN coexisted with acute tubulointerstitial nephritis in 2 patients (18.2%).(4)Seven patients received MP /CTX with treatment, and others just got allopathic treatment,10 patients acquired remission after treatment.Conclusion:IgA nephropathy can complicated with ARF,and the pathology lesion varied.The progression of these patients is well,and most patients can acquire remission.

关 键 词：急性肾衰竭 IGA肾病 病理学 肾小球肾炎 过敏性紫癜 

分 类 号：R692.3[医药卫生—泌尿科学]