138例IgA肾病病理分型与临床分析

IgA nephropathy pathology classification and clinical analysis of 138 cases

目的探讨不同IgA肾病病理分级与临床特征间的关系。方法回顾性分析138例经肾活检病理确诊为IgA肾病的病理资料,系统分析各个病理分级之间的关系及病理分级与年龄、血白蛋白、24小时尿蛋白定量、尿素氮、血肌酐、血红蛋白、C3、C4、IgA、IgA/C3、IgM、IgG、胆固醇、甘油三酯、低密度胆固醇、高密度胆固醇等临床表现之间的相互关系。结果病理分型中Ⅰ级占5.80%,Ⅱ级占18.84%,Ⅲ级占50.00%,Ⅳ级占21.74%,V级占3.62%。病理分型以Ⅲ级较为多见;IgA肾病病理分级之间血肌酐有非常显著性差异(P<0.01),与年龄、血白蛋白、尿素氮、C4、IgA、IgM、低密度胆固醇无明显相关性(P>0.05)。结论 IgA肾病病理表现多样性,与临床各实验室指标具有不平行性,早期行肾活检明确病理类型有助于指导治疗及判断预后。

Objective Discuss the relationship between different IgA nephropathy pathological grading and clinical featureK Methods Retrospective analysis of 138 cases of the IgA nephropathy pathological datas which were diag- nosed by renal biopsy pathology, Systematic analysis of the relationship between the various pathologic stage and the re- lationship between the pathologic stage and the clinical manifestation, such as age, 24 hours urinary protein, blood albu- min quantitative, urea nitrogen, serum creatinine, hemoglobin, C3, C4 and IgA, IgA/C3, IgM and IgG, cholesterol, tri- glyceride,low density cholesterol, HDL cholesterol,etc. Results Pathological type of Class I accounted for 5.80 %, ]] class accounted 18.84%, I]] grade accounted 50.00%, IV class accounted 21.74% ,V class accounting for 3.62%. Path- ological type of Class Ill more than others;The pathological grading of IgA has obvious significant difference with ser- um creatinine （P 0. 01）, but has no significant correlation With age, serum albumin, blood urea nitrogen, C4, IgA, IgM,LDL cholesterol （P0.05）. Conclusion IgA nephropathy pathological manifestations are diversity and have not parallel to each index of clinical laboratory parameters, Clearly pathological type by early renal biopsy helps guide treat- ment and prognosis.