成人IgM肾病的临床及病理特点43例分析

Analysis of clinical and pathological features in 43 adult patients with IgM nephropathy

目的探讨成人IgM肾病临床及病理特点。方法 43例IgM肾病患者根据临床表现分为肾病综合征组(A组,19例)、非肾病综合征组(B组,24例),分析两组患者的临床及病理特点。结果 A组24-h尿蛋白、血压、血清IgM水平和血沉高于B组,血清白蛋白和IgG水平低于B组(P<0.05)。A组和B组肾脏中IgM荧光强度与系膜增生、24-h尿蛋白和血清IgM水平呈正相关。两组电镜下见足突部分、广泛融合。结论 IgM肾病作为成人原发性肾小球肾炎之一,临床表现多样,以肾病综合征为主。有肾病综合征表现者临床表现和病理病变均较重。

Objective To explore the clinical and pathological characteristics of IgM nephropathy in adults.Methods On the basis of clinical manifestation,43patients with a diagnosis of IgM nephropathy were divided into two groups of A（19cases,manifested as nephrotic syndrome）and B（24cases,manifested as non-nephrotic syndrome）.The clinical and pathological features were compared.Results The urinary protein quantitation,blood pressure,serum IgM and erythrocyte sedimentation rate were higher in group A than those in group B（P〈0.05）.Serum albumin and IgG were lower in group A than those in group B（P〈0.05）.The fluorescence intensity of IgM in renal tissue of both groups was positively correlated to mesangial proliferation,24-h urinary protein quantitation,serum IgM.There was part or extensive foot process fusion seen under electron microscope in two groups.Conclusion IgM nephropathy as one of the primary glomerulonephropathy diseases in adults presents different clinical manifestations,but nephrotic syndrome is the most common.The clinical manifestation and pathology are more severe in IgM nephropathy patients with the manifestations of nephrotic syndrome than those without.