血管病变在IgA肾病、系膜增殖性肾小球肾炎及膜性肾病中的比较  

Comparison of intrarenal artery lesions in patients with IgA nephropathy,mesangial proliferative glomerulonephritis and membranous nephropathy

作　　者：吴杰[1] 陈香美[1] 谢院生[1] 师锁柱[1] 

机构地区：[1]解放军总医院肾科解放军肾病中心暨重点实验室,北京100853

出　　处：《军事医学科学院院刊》2005年第3期251-253,共3页Bulletin of the Academy of Military Medical Sciences

基　　金：国家重点基础研究发展规划"973"资助项目(G2000057000);国家自然科学基金创新研究群体科学基金资助项目(30121005)

摘　　要：目的:了解血管病变在IgA肾病(IgAN)与系膜增殖性肾小球肾炎(MsPGN)及膜性肾病(MN)中的不同特点。方法:回顾性分析1005例IgAN患者、627例MsPGN患者和221例MN患者血管病变的发生率、病变程度及病变类型。结果:1005例IgAN患者、627例MsPGN患者和221例MN患者肾活检组织中血管病变的发生率分别为54.6%,26.6%和47.1%,血管病变发生的平均年龄分别为34.6,40.4和47.7岁,中/重度血管病变的比例分别为37.0%,21.6%和23.1%,合并血管玻璃样变的比例分别为43.7%,16.8%和21.2%,上述4项指标三者之间均存在明显差异(P<0.05)。在IgAN患者中,有高血压者出现血管壁增厚合并玻璃样变的比例明显高于无高血压者(P<0.001)。结论:IgAN患者较MsPGN及MN患者血管病变的发生比例高,出现的年龄轻、程度重,合并玻璃样变的比例高。在IgAN患者中高血压的发生可能与血管的玻璃样变关系密切。Objective:To analyze and compare the characteristics of intrarenal artery lesions in IgA nephropathy (IgAN), mesangial proliferative glomerulonephritis without IgA deposits(MsPGN)and membranous nephropathy (MN). Methods:The incidence, degree (mild, moderate or severe) and different pathological types (arterial wall thickening (alone) or arterial wall thickening with hyaline change) of intrarenal artery lesions in patients with IgAN, MsPGN and MN were investigated retrospectively.Results:The incidences of intrarenal artery lesions were 54.6%, 26.6% and 47.1%, average ages of artery lesion patients were 34.6, 40.4 and 47.7 years, percentages of moderate/severe artery lesions were 37.0%, 21.6% and 23.1%, percentages of arterial hyaline change were 43.7%, 16.8% and 21.2% in 1 005 IgAN patients,627 MsPGN patients and 221 MN patients, respectively. Comparisons of above four indices between IgAN and MsPGN or MN were statistically different(P<0.05).The percentage of hyaline change in patients with hypertension was higher then that in patients without hypertension in the IgAN patients. Conclusion:The intrarenal artery lesions of IgAN have the characteristics of higher incidence, younger age, more severe lesion and higher percentage of hyaline change compared with MsPGN and MN. In IgAN patients, hypertension may be related to hyaline change.

关 键 词：血管疾病 肾小球肾炎 IgA 肾小球肾炎 膜增生性 肾小球肾炎 膜性 

分 类 号：R692.3[医药卫生—泌尿科学]