IgA肾病79例临床参数与病理分型相关因素分析

Clinical presentation and pathologic feature of 79 cases with IgA nephropathy

目的 探讨IgA肾病的临床参数与病理分型及其相关因素分析。 方法 对 79例原发性IgA肾病进行临床与病理分型关系的分析。按Lee氏分级及Katafuchi半定量积分法将肾小管间质病变分级 ,探讨血肌酐水平、尿 β2-MG、尿NAG与肾小管间质病变的相关性。结果 79例IgA肾病临床表现以无症状性尿检异常和复发性肉眼血尿最常见 ,占 74.68%。病理类型以弥漫系膜增生伴局灶节段硬化最常见 ,占 5 8.2 3 %。血肌酐水平、尿 β2 -MG、尿NAG改变与小管间质病变程度显著相关。结论 IgA肾病的临床病理表现多样化并具一定特点 ,肾活检对预后判定具有重要意义。小管间质病变是决定预后因素之一 ,尿 β2 -MG、尿NAG测定有助于了解小管间质病变。

Objective To investigate to relationship between clinical features and pathomorphological types in IgA nephropathy(IgAN).Methods The clinical features and pathomorphological types of 79 case were analyzed retrospectively. All patients were divide into three groups. Change of interstita according to Lee SM and Katafuchi semiquantitative scoring system. The realationship between serum creatinine, urine β 2-MG?urine NAG and change of tubulionterstital was studied.Results Among the 79 case of IgAN, without the presence of proteinuria and recurrent gross hematuria was the most common clinical manifestation (74.68%). Pathological, mesangial proliferative with focal segmental glomerulonephritis was the most frequent type (58.23%). There were negative correlation between serum creatinine level, urine β 2-MG, NAG and tubulointerstitial pathological process.Conclusion The relation between the clinical manifestation and pathomorphological type of IgAN is complicated. It's significant to foresight with reanal biopsy. The change of tubulointerstitial was the factor of predicting the renal functions. Test urine β 2-MG, NAG can help us to understand tubulorinterstitial pathological process.