IgA肾病不同年龄段病理特征分析

Analysis on the Pathological Features of IgA Nephropathy with Different Ages

【目的】研究IgA肾病不同年龄段病理改变的特点，为深入探讨IgA肾病的发病机制及指导治疗提供依据。【方法】选择2003年10月至2006年9月在中南大学湘雅二医院肾内科住院经肾活检确诊的281例IgA肾病患者，结合所选研究对象的临床资料和病理资料，按不同年龄段分组，分析其临床表现和病理特点的相关性。【结果】281例IgA肾病患者男女比例为1：1．13；21～30岁组病例构成比（34．9%）显著高于其他年龄组（P〈0．05），年龄≥51岁组病程最长（P〈0．05）。高血压在年龄大患者发生比例高，且随着增龄高血压构成比有增高趋势；蛋白尿患者男性明显多于女性，而血尿患者则相反（P〈0．05）。光镜下病理类型以系膜增生型（MsPGN）最多；Lee’s病理分级表现Ⅲ级最多（P〈0．01）。【结论】IgAN是一纽具有相同免疫病理特点的综舍征，本文显示其不同的病理类型与，临床表现之间存在联系，为本病的诊断和治疗提供了有力的依据。

[Objeetive]To investigate the pathologic changes of IgA nephropathy with different ages in order to discuss the pathogenesis of IgA nephropathy and provide the basis for the treatment. [Methods] Totally 281 patients with IgA nephropathy confirmed by renal biopsy in Second Xiangya Hospital of Central South University from Oct. 2003 to Sept. 2006 were chosen. The clinical data and pathological information of all patients were analyzed. According to differenet ages, all patients were grouped. The correlation between the clinical manifestation and pathological feature was analyzed. [Results]The clinical data of patients with IgA nephropathy showed that the ratio of male and female was 1 ： 1.13. There was significant difference in the mortality and disease duration among different age groups（ P 〈0.05）. The incidence of hypertension in old age patients was higher. The constituent ratio of hypertension increased with the age. The proportion of proteinuria patients in male patients was obviously higher than that in female patients, but that of hematuria patients was opposite（ P 〈0.05）. Under microscope, the most pathological type was mesangi/a proliferation （MsPGN）. The Lee＇s pathological grade showed that grade Ⅲ was the most common. [Conclusion] IgA ne- phropathy is a syndrome with identical immunological pathology features. There is a correlation between different pathology types and clinical manifectation. It provides a strong basis for the diagnosis and treatment of this disease.