小儿IgA肾病临床病理分析

Clinical pathological analysis of children IgA nephropathy

目的:探讨小儿IgA肾病(IgAN)临床病理特点。方法:对我院1984～2005年6月经皮肾活检病理检查确诊的小儿原发性IgA肾病的临床病理资料进行回顾性分析。结果:小儿IgAN临床以单纯血尿最常见(36.8%),其次是血尿伴蛋白尿(31.6%);临床表现及病理改变以肾病综合征最重,其次是血尿伴蛋白尿,易合并肾功能不全和高血压;肾病综合征的免疫复合物沉积以IgA+IgG+IgM型多见,单纯血尿、血尿伴蛋白尿以IgA+IgG型免疫复合物沉积为主。结论:小儿IgAN的临床及病理分级与治疗及其预后有关,只有通过肾活检病理检查才能更好地认识小儿IgAN,制定正确的治疗方案,客观的评估预后。

Objective ： To find out the clinical pathological character of children IgA nephropathy （IgAN） . Methods： To do the retrospective analysis of the clinical pathological data of children idiopathic IgA nephropathy diagnosed by renal biopsy from 1984 to 2005 June. Results： The common clinical IgAN ranks from pure hematuria （36. 8% ） to hematuria accompanied proteinuria （31.6%） ; the severity of clinical and pathological changes ranks from nephritic syndrome to hematuria accompanied proteinuria in which easily combined with renal failure and hypertension; the immune complexs deposit of nephritic syndrome mainly are IgA ＋ IgG ＋ IgM, but the deposit of pure hematuria and hematuria accompanied proteinuria are IgA ＋ IgG. Conclusion： The clinical and pathological grades of children IgAN relating with therapy and prognosis help better comprehend children IgAN and formulate accurate treatmemt plan and evaluate prognosis objectively only through renal biopsy.