28例老年及老年前期原发性IgA肾病的临床病理分析

Clinical pathologic analysis of 28 gerontic and gerontic early days idiopathic IgA nephropathy

目的探讨老年及老年前期原发性IgA肾病临床病理特点。方法对我院自1984年—2005年6月间经皮肾活检病理检查确诊的老年及老年前期原发性IgA肾病的临床病理资料进行回顾性分析,并与同期行肾活检病理检查的青壮年原发性IgA肾病进行比较。结果老年及老年前期原发性IgA肾病的临床类型主要以慢性肾炎最常见(39.3%),病理类型主要以硬化性肾小球肾炎(SGN)最常见(35.7%);青壮年组原发性IgA肾病的临床类型主要以无症状性尿检异常最常见(65.3%),病理类型主要以局灶节段性肾小球硬化(FSGS)最常见(36.3%)。老年及老年前期组的蛋白尿、肾病综合征、慢性肾衰和高血压的发生率均高于青壮年组。结论老年及老年前期原发性IgA肾病的临床病理表现呈多样化,并且具有一定特点,只有通过肾活检才能了解病理改变情况,更好地认识疾病的性质。

Objective To tint out the clinical pathology character of gerontic and gerontic early days idiopathic IgA nephropathy. Methods To do the retrospective analysis of the clinical pathologic data in the gerontic and gerontic early days idiopathic IgA nephropathy cases diagnosed by renal biopsy from 1984 to 2005 June in our hospital and compare them with the young cases in the same period.Results Chronic nephritis （39.3%） is the most common clinical type in the gerontic and gerontic early days idiopathic IgA nephropathy, and sclerosing glomerulonephritis（35.7 % ） is the most common pathological type; the most common clinical type in the young group is symptomless abnormal urine（65.3% ） and focal segmental glomerulonephritis（FSGS） is the most common pathological type in this group. Incidence of proteinuria, nephritic syndrome, chronic renal failure and hypertension in the gerontic and gerontic early days group is higher than the young group. Condusion The clinical pathological types of the gerontic and gerontic early days idiopathic IgA nephropathy are diverse and characteristic, we only can comprehend the pathological changes and master the hatare of the disease by renal biopsy.