IgA肾病临床表现与肾小球超微病理改变的关系

Ultrastructural Changes in IgA Nephropathy in Relation to Clinical Data

目的探讨ＩｇＡ肾病（ＩｇＡＮ）临床表现与超微病理改变之间的联系。方法对１２２例肾活检标本进行系统的超微结构观察，以半定量方法对各项超微病变进行分级，并和肾小球损伤程度及临床分型相对照，进行统计学处理。结果肾小球系膜旁区半球形沉着物、基膜内皮下或上皮下沉着物、系膜溶解、系膜细胞插入和基膜异常均与肾小球损伤程度呈正比。系膜溶解以外的各种超微病变，其程度在不同临床类型中有显著差异。结论ＩｇＡＮ众多临床表现各有其相应的超微结构病变。

Objective\ To investigate the relationship between ultrastructural changes and clinical manifestations.\ Methods\ The ultrastructural\ changes of renal biopsy specimens taken from 122 cases were studied,and were evaluated by semiquantitative method, then compared with the glomerular lesion grading,clinical types and immunological types statistically.\ Results\ Hemispherical deposits in paramesangium,mesangiolysis paramesangial destructive lesions, subendothelial or subepithelial dense deposits in glomerular capillary wall, glomerular basement membrane abnormality and mesangial interposition related positively to the severity of glomerular lesion by statistics, and also associated with clinical syndromes significantly except for mesangiolysis.\ Conclusion\ A varieties of clinical syndromes in IgA nephropathy have its corresponding ultrastructure changes, and the degree of which has important significance for predicting prognosis and guiding treatment.