反复黏膜感染的IgA肾病临床病理特点  

The Clinical and Pathological Characteristics of IgAN with Recurrent Mucous Infection

作　　者：李青[1] 张紫媛[1] 樊均明[1] 

机构地区：[1]四川大学华西医院肾脏内科,成都610041

出　　处：《华西医学》2012年第5期652-657,共6页West China Medical Journal

基　　金：国家自然科学基金(81170667)~~

摘　　要：目的总结反复黏膜感染的IgA肾病的临床病理特点。方法采用单中心流行病学调查及回顾性研究,收集2006年1月-2009年12月253例经肾活检确诊为IgA肾病的住院患者的临床病理资料,对114例反复黏膜感染的IgA肾病患者(A组)及139例偶发或从未发生黏膜感染的IgA肾病患者(B组)的临床病理指标进行比较。结果 A组患者年龄较B组小(t=2.913,P=0.004),临床表现无明显症状者比例较B组多,临床分型以反复发作肉眼血尿型为多,病理分级较B组轻(Z=2.042,P=0.041),IgA+IgM+C3沉积率高(P<0.001);B组IgA+IgG+C3沉积率高(P<0.001),纤维连接蛋白沉积率高(P<0.001)。结论反复黏膜感染的IgA肾病组患者年龄小,反复发作肉眼血尿型多,临床表现及病理分级较轻;两组FN沉积及免疫球蛋白沉积的主要类型不同,提示两组发病机制可能有所不同。Objective To search the clinical and pathological characteristics of IgA nephropathy（IgAN） with recurrent mucous infection and get a further understanding of the pathogenesis and the relation between mucous infection and IgAN.Methods The clinical and pathological features of 253 patients with IgAN diagnosed between January 2006 and December 2009 were reviewed.The patients were divided in two groups,including 114 patients with recurrent mucous in group A and 139 patients with occasional mucous infection group B.Results The age of patients in group A was younger than that of patients in group B.More clinical types of recurrent macroscopic hematuria were found in group A than those in group B.The main immunoglobulin deposition was IgA＋IgM＋C3 in patients in group A,while was IgA＋IgG＋C3 in patients in group B.Less patients in group A had deposition of fibronectin.Conclusions Patients with IgAN having mucous infection are young and have more clinical type of recurrent macroscopic hematuria with milder clinical and pathologic features.These results may predict different pathogenesis between the two groups.

关 键 词：黏膜感染 IGA肾病 免疫球蛋白沉积 纤维连接蛋白沉积 预后 

分 类 号：R692.3[医药卫生—泌尿科学]