局灶节段性肾小球硬化病损在IgA肾病中的意义

Assessment of the Damage of Secondary Focal Segmental Glomerulosclerosis in IgA Nephropathy.

目的探讨局灶节段性肾小球硬化病变(sFSGS)在IgA肾病(IgAN)中的临床意义。方法对182例IgAN-sF-SGS患者的临床与病理资料进行相关性分析。结果IgAN-sFSFS中以无症状尿检异常最常见(占50·55%),其次是高血压伴/不伴慢性肾功能衰竭和大量蛋白尿/肾病综合征。随着sFSGS病变的加重,尿蛋白量、血肌酐、尿素氮、尿酸也相应增高。病理分析显示sFSGS与炎细胞浸润、间质纤维化、小管萎缩和血管病变有相关性(r1=0·377,r2=0·169,r3=0·412,r4=0·331;P<0·05)。结论sFSGS是IgAN判断预后的重要指标。

Objective To assess the damage of secondary focal segmental glomerulosclerosis （sFSGS） in IgA nephropathy （IgAN） . Methods Clinical and pathological data on 182 patients with IgAN were analysed quantitatively , who had pathological damage of sFSGS. The clinical data included gender, age, blood pressure, urine protein, serum creatinine （Scr）, blood urea nitrogen （Bun）, uric acid （UA）, blood cholesterol （Ch）, triglycerides （TG）, serum total protein （TP）, albumin （Alb） and creatinine clearance rate （Ccr） .3he data of pathology included quantitive integration in focal and segmental glomerulosclerosis, cellular proliferation, mesangial proliferation, crescent, inflammatory cell infiltration, interstitial fibrosis, tubule atrophy and anglo - lesion. The multivariate over univariate statistical analyses had been done, finding the correlation among the factors.Results 3he most coromon clinical type of 182 patients＇ was asymtomatic urine abnormality （50.55%）, then were hypertension with/no chronic renal function failure and mass proteinura/nephrotie syndrome. The quantitive value of urine protein, Scr, Bun and UA increased as exacerbation of sFSGS＇ degree.It showed that inflammatory cell infiltration, interstitial fibrosis, tubule atrophy and angio - lesion had intimate correlation with sFSGS （ r1 = 0.377, r2 = 0.169, r3 = 0.412, r4 = 0.331, P 〈 0.05） . Conclusion These data suggest that abSGS is an important indication of prognosis in patients with IgAN.