IgA肾病患者肾小动脉病变与临床及病理特点的相关性

Correlation between clinical and pathological features and renal arterioles lesions in patients with IgA nephropathy

目的探讨IgA肾病患者肾小动脉病变与临床、病理的相关性。方法 60例IgA肾病患者,根据肾小动脉病变程度分为未见明显病理改变组(A组,25例)、肾小动脉增厚组(B组,31例)和肾小动脉增厚伴透明样变组(C组,4例),分析三组肾小动脉病变程度与其临床指标及病理学参数的相关性。结果三组肾小动脉病变程度与血肌酐水平(P<0.01)、血尿酸(P<0.05)、收缩压(P<0.05)、舒张压(P<0.05)呈明显正相关。三组肾小动脉病变程度与内皮细胞增生指数(P<0.01)、系膜细胞增生指数(P<0.05)、肾小球慢性化指数(P<0.01)、间质炎症指数(P<0.01)、肾小管萎缩纤维化指数(P<0.05)呈明显正相关。结论肾小动脉病变在IgA肾病中病情评估中有重要作用,可作为预测肾脏预后的指标之一。

Objective To analyze the correlation of the clinical and pathological features and the pathological changes of renal arterioles in the patients with IgA nephropathy. Methods A total of 60 patients with IgA nephropathy was divided into 3 groups of A（25 cases, without pathological changes of renal arterioles）, B（31 cases, with incrassation of the renalarterioles） and C （4 cases, with incrassation and transparent kind of change of the renal arterioles）. The correlation of the clinical and pathological features and the pathological changes of renal arterioles was analyzed. Results The pathological changes of renal arterioles were positively correlated to serum creatinine level（P〈0. 01 ）, uric acid（P〈0. 05）, systolic blood pressure （P^0. 05） and diastolic blood pressure （P〈0. 05）. The pathological changes of renal arterioles were positively correlated to the endothelial cell hyperplastic index（P〈0. 01）, the mesangial cell hyperplastic index （P〈0. 05）, the glomerular chronicity index （P〈0. 01）,the mesenchyme inflammation index（P〈0. 01） and the kidney tubules atrophy fibrosis index（P〈0. 05）. Conclusion The pathological changes of renal arterioles are important in evaluating the severity of renal lesions and can be taken as one of the indicators for predicting the prognosis in the patients with IgA nephropathy.