小儿IgA肾病免疫荧光表现及其意义

SIGNIFICANCE OF IMMUNOFLUORESCENCE FINDINGS IN CHILDREN WITH IGA NEPHROPATHY

本文报告和分析了20例小儿IgA肾病的免疫荧光表现及其与临床表现和病理改变之间的关系。8例IgA单独沉积于系膜区(组1);12例同时有毛细血管壁沉积(组2)。临床上以急性肾炎和持续血尿起病者均在组2。两组虽各有1例肾病综合征,但组1病例对皮质激素治疗呈完全效应,组2病例则为部分效应。组2肾小球病变≥2度,肾小管间质病变≥++者显著多于组1(P <0.05)。肾小球有无IgM沉积和小球有无硬化改变无关。虽然IgA荧光强度≥++在组2显著多于组1(P<0.05),但≥+++两组无显著差异。

This paper reports and analyses the immunofluorescence features of 20 children with IgA nephropathy, and correlation between immunofluorescence features, clinical manifest and pathological changes in kidney. According to the children without GBM deposition of IgA or with GBM deposition of IgA, twenty patients were grouped in to two groups, namely group 1 (8 cases) and 2 (12 cases). The patients who had the symptoms of acute glomerulonephritis or persistent hematuria at onset of the disease were in group 2. The severity of glomerular damages of both groups had significant difference. The children with more severe glomerular damages (≥2) were significantly more in group 2. The children with more severe tubular atrophy and/or interstitial fibrosis (≥++) in group 2 were also more than in group 1. We failed to demostrated correlation between the deposition of IgM in glomeruli and glomerulosclerosis. Although the patients with IgA immunofluorescence ≥ + + were significant more in group 2. but the patients with IgA≥+++ in group 9 were not significant more than in group 1 .