陕西地区IgA肾病的病理和流行病学特点

The pathologic and epidemic characteristics of 618 cases with IgA nephropathy in Shaanxi area

目的了解陕西地区15年来IgA肾病的病理和流行病学特点.方法回顾性分析618例IgA肾病的流行病学和病理特点.结果本地区IgA肾病男性多见,发病高峰年龄为16～40岁,发病占同期原发性肾小球肾炎的32.46%,病程较短;临床表现具有多样性,肾病综合征最多见,肉眼血尿随年龄增加而减少,肾功能不全和高血压随年龄增大而增多;小球内固有细胞的增生程度、新月体形成和小管间质病变对肾功能影响明显;肾功能不全与年龄、病程和病变之间无明显的规律性对应关系.结论陕西地区原发性肾小球肾炎中IgA肾病所占比例高,男性多见;IgA肾病某些临床表现在各年龄组间有显著性差异;IgA肾病的小球病变与肾小管、间质及血管病变程度不一定平行,依据病理变化制定有个性化特点的IgA肾病治疗方案尤为重要.

Objective To understand the pathologic and epidemic characteristics of IgA nephropathy during the past fifteen years in Shaanxi area. Methods The clinical and pathological characteristics of 618 cases with IgA nephropathy were analyzed retrospectively. Results The incidence in males was relatively higher than that in females. In primary glomerulonephritis, the IgA nephropathy took up 32.46% with short duration at the same time; the peak age of onset was between 16-40 years old. The manifestations of IgA nephropathy showed diversity, but the nephritic syndrome was the most common one. With the increasing of ages, the incidence rate of hematuria under nakeds eyes was decreased, but the incidence rate of hypertension and renal failure were increased. The degree of mesangial cell proliferation, formation of crescent, and renal tubule and interstitial lesions had obvious effect on renal function. The pathological change of glomerulus of IgA nephropathy did not correspond with pathological changes of renal tubule, interstitium, and blood vessel. Conclusion IgA nephropathy takes up a high incidence rate in primary glomerulonephritis in Shaanxi area and high incidence rate in males. At the same time, the manifestations of IgA nephropathy show significant differences among each age group, and the lesions of glomeruli have no significant correlation with the renal tubule and interstitial lesions. Understanding the pathological changes of IgA nephropathy is very helpful to form specific treatment to each individual.