IgA肾病诊疗进展  

Progress of research on diagnosis and treatment for IgA nephropathy

作　　者：许国双[1] 周美兰[1] 柏明[1] 王汉民[1] 孙世仁[1] 

机构地区：[1]第四军医大学西京医院肾脏内科,西安710032

出　　处：《中华肾病研究电子杂志》2016年第5期203-208,共6页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

基　　金：国家自然科学基金资助项目(81470993;81272621);西京医院新技术新业务(XJGX15Y45)

摘　　要：IgA肾病是全球最常见的原发性肾小球肾炎,亚洲人群中发病率高于其他人种。IgA肾病是目前导致终末期肾病的重要原因之一。临床上以血尿为特点,常伴随蛋白尿、高血压。其病理表现主要为IgA免疫复合物在肾小球系膜区的沉积、系膜细胞增生、毛细血管内皮细胞增生等。其发病机制可能为血液循环中半乳糖缺乏的IgA1增多,在內外界环境刺激下,产生过多的、能沉积于肾小球系膜区的免疫复合物。目前,对IgA肾病的诊断主要依靠病理检查。治疗方面,以肾素-血管紧张素系统阻断剂、控制血压为基础,恰当联合免疫抑制剂、细胞毒性药物、鱼油等或能延缓IgA肾病的进展。本文的目的是对IgA肾病的诊疗现状进行总结和分析,为临床工作及进一步科研提供指导和参考。IgA nephropathy （IgAN） is the most common primary glomerulonephritis worldwide, with especially higher morbidity in Asian population. Currently, IgAN is one of the important causes for endstage renal disease, with clinical features including hematuria, proteinuria, and hypertension. The major pathological characteristics of IgAN are IgA deposits in the glomerular mesangium, mesangial cell proliferation, and capillary endothelial cell proliferation. Elevated circulating levels of galactose-deficient IgA1 （Gd-IgA1）, increased production of immune complexes of Gd-IgA1, and deposition of these complexes in glomerular mesangium are the widely accepted mechanism of IgAN. Kidney biopsy remains the only definitive method for diagnosing IgAN. Current treatments for IgAN are based on renin-angiotensin system blockade and management of blood pressure, the combination of which with appropriate immunosuppressants, cytotoxic drugs, and fish oil might be able to delay the progression of IgAN. The purpose of present review was to summarize the progress of research on diagnosis and treatment for IgAN to provide data and guidance for further clinical work and scientific research.

关 键 词：IGA肾病 机制 治疗 

分 类 号：R692.31[医药卫生—泌尿科学]