IgA肾病402例临床病理分析  

Clinicopathological analysis of 402 cases with IgA nephropathy

作　　者：张秋花[1] 王凉[1] 刘斌[1] 祁真[1] 陈彩妹[1] 孙铸兴[1] 

机构地区：[1]南京医科大学附属无锡人民医院肾脏病科,江苏省214023

出　　处：《江苏医药》2013年第2期173-175,共3页Jiangsu Medical Journal

摘　　要：目的探讨不同类型IgA肾病(IgAN)的临床病理特征。方法回顾性分析402例肾活检确诊为原发性IgAN的临床病理资料。IgAN分为孤立性镜下血尿型(I-H)、无症状尿检异常型(U-ab)、反复发作肉眼血尿型(R-GH)、血管炎型(Vas)、大量蛋白尿型(MP)、高血压型(HT)六种类型。结果临床上以U-ab、HT最多见,病理上以Lee分级Ⅱ、Ⅲ级最多见。免疫荧光最多见的是IgA型、IgA+C3型及IgA+IgM+C3型。随着肾功能的恶化及病理损伤程度的加重,24-h尿蛋白、血清肌酐有逐渐增加而肾小球率过滤(eGFR)、血红蛋白有逐渐降低的趋势。eGFR对肾脏病理损害影响最大。结论 IgAN临床和肾脏病理存在着紧密的联系。Objective To analyze the clinicopathological characteristics of different types of IgA nephropathy（IgAN）. Methods Retrospective analysis of clinical and pathological data of 402 primary IgAN cases diagnosed with renal biopsy was performed.IgAN was divided into 6 types of isolated hematuria（I-H）,asymptomatic urinary abnormality（U-ab）,recurrent gross hematuria（R-GH）,vasculitis（Vas）,massive proteinuria（MP） and hypertension（HT）. Results U-ab and HT were clinically the most common IgAN.Lee grade Ⅱ and Ⅲ were pathologically the most common IgAN. IgA type,IgA＋C3 type and IgA＋IgM＋C3 type were the most common types on the immunofluorescence. As the deterioration of renal function and the severity of pathological damage increased,the 24-hour urine protein and serum creatinine were increased,but estimated glomerular filtration rate（eGFR） and hemoglobin gradually decreased.eGFR was the greatest factor to impact renal pathological damage. Conclusion The clinical manifestations of IgAN is closely associated with renal pathology.

关 键 词：IGA肾病 

分 类 号：R692[医药卫生—泌尿科学]