IgM沉积强度对原发性IgA肾病患者肾小球超微结构及临床病理的影响  

Impact of IgM deposition level on the ultrastructure and the clinicopathological features of primary IgA nephropathy patients

作　　者：徐璐[1] 张晶晶[1] 闫奇奇 许雯婷 黎淮[1] 王德光[1] XU Lu;ZHANG Jingjing;YAN Qiqi;XU Wenting;LI Huai;WANG Deguang(Depart-ment of Nephrology,Second Affiliated Hospital of Anhui Medical University,Hefei 230601,Anhui,China)

机构地区：[1]安徽医科大学第二附属医院肾脏内科,安徽合肥230601

出　　处：《实用医学杂志》2024年第22期3172-3178,共7页The Journal of Practical Medicine

基　　金：安徽省自然科学基金面上项目(编号:2008085MH244);安医大二附院国自然孵育计划项目(编号:2020GMFY04);安徽医科大学校科研基金项目(编号:2021xkj171)。

摘　　要：目的探讨原发性IgA肾病(IgA nephropathy,IgAN)患者不同IgM沉积强度与肾小球超微结构病变及临床病理的关系。方法收集155例IgAN患者的临床病理资料。分为IgM阴性(51例)、轻度(89例)和中度及以上沉积(15例)3组。比较3组间肾小球超微特征性结构、临床指标、MEST-C评分差异并分析与IgM沉积强度的影响因素。结果与IgM阴性、IgM轻度沉积组相比,IgM中度及以上沉积组24 h尿蛋白水平、IgG沉积、肾小管萎缩/间质纤维化(T)评分、足突融合(foot process effacement,FPE)程度更高,血白蛋白水平、淋巴细胞计数更低(P<0.05)。logistic结果显示FPE程度、T评分是IgM沉积强度的独立影响因素。结论IgM沉积强度与原发性IgAN患者FPE程度相关。FPE程度可协同临床病理评分更精准评估肾组织损伤及制定治疗方案。Objective To investigate the correlations between IgM deposition levels,glomerular ultra-structural and clinicopathological features in primary IgA nephropathy(IgAN).Methods Data from 155 IgAN patients were categorized into three cohorts by IgM deposition levels.We assessed differences in glomerular ultra-structure,clinical indices,MEST-C scores,and factors influencing IgM deposition levels.Results The marked IgM cohort showed higher urinary protein,IgG deposition,and T scores,with reduced serum albumin and lympho-cyte counts(P<0.05).Logistic regression identified FPE and T score as independent factors for IgM deposition.Conclusions IgM deposition correlates with FPE severity in IgAN,suggesting its utility in assessing renal dam-age and guiding treatment strategies.

关 键 词：IGA肾病 IgM沉积 足突融合 电子显微镜 

分 类 号：R692.3[医药卫生—泌尿科学]