云南地区IgA肾病的病理及临床特点

Pathological Type and Clinical Characteristics of IgA Nephropathy in Yunnan

目的探讨云南地区IgA肾病的病理类型及临床特点.方法对2008年1月至2011年9月间在昆明医学院附属延安医院肾脏内科进行肾穿刺活检术,并且病理检查确诊为IgA肾病的50例患者的病理分级与临床特点进行分析,探讨其变化规律.结果 IgA肾病占肾活检的百分率为17.4%,50例IgA肾病的临床表现以镜下血尿为主(76%),少于1 g的蛋白尿次之,临床诊断以慢性肾小球肾炎(包括无症状血尿和/或无症状蛋白尿)为主(78%),病理分级以Lee氏II级为多(44%),III级次之(36%),IV、V级也有一定比例.结论对于临床上有肾脏损害指标的患者(血尿、蛋白尿和肾功异常者)应及时进行肾脏穿刺活检了解病理类型,积极给予干预治疗,减少终末期肾病(ESRD)的发生.

Objective To investigate the pathological type and clinical characteristics of IgA nephropathy in Yunnan. Methods We analyzed the pathological grade and the clinical characteristics of 50 patients diagnosed as IgA nephropathy based on renal biopsy in our department from January 2008 to September 2011, and explored their changing patterns. Results IgA nephropathy accounted for 17.4% of all patients with renal biopsy, 50 patients with IgA nephropathy had microscopic hematuria （76%） as the main clinical manifestations, followed by less than 1 gram of proteinuria, the clinical diagnosis of chronic glomerulonephritis （including asymptomatic hematuria and / or asymptomatic proteinuria） dominated （78%） , grade II according to Lee＇s accounted for 44%, followed by grade III （36%） , grade IV, V accounted for a certain percentage. Conclusion The patients with kidney damage （hematuria, proteinuria and abnormal renal function） should be timely understanding of the pathological type based on renal biopsy, active intervention should be given to reduce the occurrence of end-stage renal disease （ESRD）.