IgA肾病68例临床与病理分析及分型治疗

Clinicopathological study and treatment of 68 cases of IgA nephropathy.

目的 研究IgA肾病临床与病理特点及相互关系，观察分型治疗的疗效。方法对68例IgA肾病病人临床和病理特点及其关系进行分析，依据其特点采用雷公藤多甙、代文、强的松等不同的治疗方案。结果 68例病人均有血尿（伴或不伴蛋白尿），病理表现重者临床表现也重。68例病人病理类型多样，以系膜增生性肾炎最多，其次为局灶节段性病变，分别占69．1％和11．8％。病理分级以Ⅱ级和Ⅲ级最多，占88．2％。分型治疗8周后显效率48．5％，有效率36．8％，无效率14．7％。结论 IgA肾病临床及病理表现多样化并具有一定的特点和联系，应采取分型治疗的原则。

AIM To investigate the relationship betweenclinical features and pathomorphological types in IgA nephropathy. METHODS The clinical features and pathomorphological types of 68 patients were analyzed, according to which individualized treatments were employed. RESULTS All the patients studied had hematuria with or without proteinuria. More severe clinical manifestations were seen in patients in advanced pathological stages. Mesangial proliferative nephritis accounted for 69.1% of the patients, followed by focal glomerulonephritis, 11.8 %. The overall response rate was 85.3 % after 8 - week individualized treatment. CONCLUSION Clinical manifestations are related to pathological stages. Individualized treatment should be given according to the clinical features and pathomorphological types.