小儿IgA肾病30例临床与病理分析

Clinical and pathologic analysis of 30 cases of children IgA nephropathy

目的 了解小儿 Ig A肾病 ( Ig A nephropathy,Ig AN)临床、病理及与预后的关系。方法 对肾活检病理诊断为 Ig AN的 3 0例病例进行临床与病理分析。结果 小儿 Ig AN临床表现以单纯肉眼血尿最常见 ,其与血尿伴蛋白尿者免疫复合物沉积均多为 Ig A+Ig G型 ,但前者临床及病理改变相对轻于后者。肾病综合征 ( NS)的临床及病理改变最重 ,易合并肾功能不全、高血压 ,以 Ig A+Ig G+Ig M型的免疫复合物沉积为主。结论 小儿 Ig AN预后与临床及病理分级有关 ,单纯肉眼血尿预后较好 ,NS、病理改变有肾小球硬化及免疫复合物沉积为 Ig A+Ig G+Ig M型者预后不良。

Objective To investigate the relationship between clinical manifestations and pathology as well as prognosis Methods Thirty children with IgA nephropathy (IgAN) diagnosed by renal biopsy were analyzed clinically and pathologically Results The common manifestations of children IgAN is pure gross hematuria,the most common type of immune complex (IC) deposits was IgA+IgG both in hematuria patients and in hematuria combined with proteinuria patients,but the clinical and pathological changes in the latter were more serious than in the former The clinical and pathological changes of nephrotic syndrome (NS) were the most serious which usually had renal dysfunction and hypertension and the major IC deposits were IgA+IgG+IgM Conclusions The prognosis of children IgAN is related to the clinical and pathologic degree The prognosis is better in pure gross hematuria patients than in NS,glomerular sclerosis and IgA+IgG+IgM deposits patients