原发性IgA肾病的临床病理特点  

Clinical and Pathological Characteristics of Primary Immunoglobulin A Nephropathy

作　　者：叶薇 王昱[1] 沈玛丽[1] 杜国伟[1] 鲍晓荣[1] 

机构地区：[1]复旦大学附属金山医院肾内科,上海201508

出　　处：《中国临床医学》2013年第4期515-517,共3页Chinese Journal of Clinical Medicine

摘　　要：目的：探讨原发性IgA肾病（primary immunoglobulin A nephropathy）患者的临床和病理特点。方法：将167例原发性IgAN患者按照24 h尿蛋白量分为A组（0~1.0g/24 h）、B组（1.0~3.5 g/24 h）、C组（〉3.5 g/24 h）,比较3组患者的临床和病理指标;再按照肾活检时的血尿特点将167例患者分为Ⅰ组（无血尿）、Ⅱ组（镜下血尿）和Ⅲ组（肉眼血尿）,比较这3组患者的临床和病理指标。结果：C组患者发生高血压、肾衰竭、高尿酸血症、高三酰甘油血症的比例高于A、B两组,C组患者超质量及肥胖的比例高于A组,B、C两组间质细胞浸润、肾小球硬化、肾小管萎缩、肾间质纤维化的病理积分高于A组。随着血尿程度的增加,与预后不良有关的大部分临床和病理指标变化并不明显。结论：原发性IgAN的病理表现与蛋白尿量不完全平行;血尿的严重程度与IgAN的预后可能无显著相关性。Objective：To investigate the clinical and pathological characteristics of primary Immunoglobulin A Nephropathy.Methods：According to the amount of 24 h urine protein（UP）,167 IgAN patients were divided into 3 groups：Group A（0~1.0 g）,Group B（1.0~3.5 g）and Group C（≥3.5 g）.The clinical and pathological data of patients in 3 groups were compared.According to the situation of the hematuria at the time of biopsy,167 patients were divided into GroupⅠ（without hematuria）,GroupⅡ（microscopic hematuria）and GroupⅢ（macroscopic hematuria）,and the clinical and pathological datas of patients in3 groups were compared.Results：The incidences of hypertention,renal failure,hyperuricemia,hypertriglyceridemia in Group C were higher than those in Group A and Group B.The ratios of obesity and overweight in Group C were higher than that in Group A.The pathological scores of interstitial infiltration,glomerulosclerosis,tubular atrophy and interstitial fibrosis in Group B and Group C were higher than those in Group A.The severity of hematuria was probably not associated with the prognosis of IgAN.Conclusions：The pathological presentation of primary IgAN is not completely paralleled by the amount of 24 h UP.The severity of hematuria may be not correlated with the prognosis of IgAN.

关 键 词：IGA肾病 蛋白尿 血尿 临床特点 病理特点 

分 类 号：R692[医药卫生—泌尿科学]