IgA肾病伴新月体形成的临床病理特征  

Clinical and pathological characteristics of primary IgA nephropathy with crescent formation

作　　者：胡小芹[1] 刘波[1] 范德墉[1] 

机构地区：[1]湖州市中心医院,浙江湖州313000

出　　处：《现代实用医学》2006年第8期538-540,共3页Modern Practical Medicine

摘　　要：目的探讨新月体形成呈局灶节段性损害的IgA肾病的临床病理特征。方法对28例经肾活检确诊伴局灶节段性新月体形成的IgA肾病与同期36例不伴新月体形成的IgA肾病的临床指标及病理参数进行比较。肾脏的病理改变按Lee标准分级,Katafuchi半定量积分判断肾小球、肾小管及肾血管的病变程度,新月体指数参照Fofi C的计算法。结果血尿在两组中分布有差异(P<0.01);两组间质炎性细胞浸润、球性硬化、间质纤维化、肾小管萎缩、血管透明变的Katafuchi半定量积分差异有显著性意义(P<0.05或<0.01);19例新月体呈细胞性和细胞及纤维性改变者新月体指数与其血尿水平有显著相关性(P<0.05)。结论伴新月体形成的IgA肾病血尿常见,肾小球、肾小管及肾血管的病变程度相对严重。建议对单纯血尿不伴有蛋白尿或微量蛋白尿的患者,只要条件许可,均应接受肾活检检查,以尽早控制病情的进展。Objective To study the clinical and thy with focal and segmental crescent formation, pathological characteristics of primary IgA nephropaMethods The clinical features and pathological parameters in 28 patients with IgA nephropathy with crescent formation （C-IgAN group） were compared with those of 36 cases with no crescents （NC-IgAN group）. All were confirmed by renal biopsy. The activity and severity of the renal lesions were graded according to Lee classification. The changes of glomeruli, renal tubules and vessels were evaluated according to Katafuchi semiquantitative scoring system. Crescentic indices were calculated by the method of Foil C. Results The level of hematuria between the two groups had significantly different （P〈0.01）. The pathological scores about inflammatory infiltration in interstitium, glomerular sclerosis, interstitial fibrosis and tubular atrophy of C-IgAN group were significantly higher than those of NC-IgAN group （P〈0.05 or P〈0.01）. The crescentic indices of 19 patients with cellulous or cellulnfibrous crescent formation were significantly correlated to the level of hematuria （P〈0.05）. Conclusion Hematuria is a familiar sight and the affections of glomeruli, renal tubules and vessels are sever relatively in C-IgAN group. The patient with isolated hematuria or mild proteinuria should be received renal biopsy properly.

关 键 词：肾小球肾炎 IGA 病理学 临床 新月体 

分 类 号：R692.31[医药卫生—泌尿科学]