524例IgA肾病的临床与病理分析

Clinical presentation and pathologic feature of 524 patients with IgA nephropathy

目的 回顾性地总结我科 １０多年来所积累的 ＩｇＡ肾病资料，包括各年龄组的发病率、临床、病理特点及其相关性。方法５２４例ＩｇＡ肾病按照年龄分成３组，根据各年龄组的临床及其组织学特点进行分析。结果少儿组复发性肉眼血尿发生率最高为 ４７． ２％，慢性肾损害为 ４ ６％。青壮年组恶性高血压的发生率为 ３．８％，也称为恶性 ＩｇＡ肾病。老年组肾病综合征和急性肾功能衰竭的发生率高于上述两组。结论随着肾活检的广泛开展，少儿和老年的 ＩｇＡ肾病的发生率也增加，尤其是少儿，必须加强对他们的随访。老年人疑为 ＩｇＡ肾病者，必须及时肾活检。青壮年 ＩｇＡ肾病仍然占大部分比例。

Objective To analyse the incidence, clinical features, histopathology and clinicopathological correlation in different age group of 524 cases with IgA nephropathy(IgAN) retrospectively. Methods 524 cases of IgA nephropathy were divided into three groups according to their age, and the clinical and renal pathological features were analyzed. Results In children group(≤15 years), the incidence of recurrent gross hematuria was 47. 2% and renal impairment 4. 6%. Malignant hypertension as first presentation associated with serious renal impairment occured in 3. 8% patients of youth and adult group (16 - 49 years). Higher incidence of nephrotic syndrome and acute renal failure was found in elder group (50 - 69 years). Conclusions The incidence Of IgAN in children and elder population is increased, especially in the children. They need a further follow-up. For elder patients considered as IgAN, a renal biopsy seems to be necessary. While youths and adults still account for the most part of IgAN patients.