IgA肾病血瘀证与肾脏病理损害的相关性分析

Correlation between Blood-stasis Syndrome and Pathological Changes in IgA Nephropathy Patients

目的研究IgA肾病血瘀证及其轻重程度与肾脏病理损害的相关性。方法对IgA肾病血瘀证进行评分,分为轻度血瘀证和重度血瘀证,分析42例IgA肾病血瘀证与73例非血瘀证患者的临床及肾脏病理资料。结果IgA肾病血瘀证临床上以肾功能衰竭多见,血瘀证女性多见;重度血瘀证伴肾功能衰竭高于轻度血瘀证;血瘀证组Lee分级重于非血瘀证组(P<0.01),重度血瘀证Lee分级重于轻度血瘀证(P<0.01);血瘀证组肾小管萎缩积分或肾小管萎缩比例明显高于非血瘀证组(P<0.05);重度血瘀证Katafichi积分、肾小球积分及肾小管-间质积分明显高于轻度血瘀证(P<0.01);血瘀证组肾组织纤维蛋白原相关抗原(FRA)沉积程度明显强于非血瘀证组(P<0.05);重度血瘀证FRA沉积程度明显强于轻度血瘀证(P<0.01)。结论血瘀证及其轻重程度与IgA肾病肾组织病理损害有一定相关性,血瘀证积分越高,肾脏病理损害程度越严重,血瘀程度可作为反映IgA肾病病变轻重程度的参考指标之一。

Objective To observe the relation between blood-stasis syndrome（BSS） and clinical pathology in IgA nephropathy patients.Methods BSS of IgA nephropathy patients was scored.According to the scores,BSS was of the mild type and the serious type.The clinicopathological materials of 42 BSS patients and 73 patients with non blood-stasis syndrome were analyzed.Results The BSS patients were often accompanied with renal failure and BSS was seen mostly in females.The incidence of renal failure in severe BSS was higher than that in mild cases. Lee＇s grade in BSS group was higher than that in non BSS group（P〈0. 01）, and Lee＇s grade in severe BSS was more serious than that in mild BSS（P〈0. 01）. The scores or ratio of renal tubule atrophy of BSS group were significantly higher than those of non BSS group. The Katafichi scores of severe BSS, scores of glomerulus and tubular interstitial lesions were significantly higher than those of mild BSS（P〈0.01）. The deposite of fibrinogen-related antigen （FRA） in renal tissues of BSS group was significantly stronger than that in non BSS group（P〈0.05）, and the deposite of FRA in renal tissues of severe BSS was significantly stronger than that of non BSS（P〈0.01）. Conclusion BSS of IgA nephropathy and its degree are correlated with renal pathological changes. The more scores of BSS, the more severity of pathological lesion. The severity of BSS might be an important influencing factor on judging the severity of IgA nephropathy.