伴高血压的IgA肾病患者流行病学及临床病理特点

The Epidemiological and Clinico-pathological Features of lgA Nephropathy with Hypertension

目的 探讨伴高血压的 Ig A肾病患者流行病学及临床病理特点。方法 5 40例 Ig A肾病分为高血压组(HP组 ,2 14例 )与非高血压组 (N- HP组 ,32 6例 )。对比分析两组流行病学及临床病理资料。结果 伴高血压的 Ig A肾病患者以男性多见、男∶女为 2 .6 3∶ 1,临床表现以蛋白尿伴血尿为主 ,其次为单纯蛋白尿 ,而呈肾病综合征伴或不伴血尿者及单纯血尿者较少见。与 N- PH组相比 ,其尿蛋白排泄量较多 ,血浆白蛋白水平较低 ,胆固醇、甘油三酯及血肌酐水平较高 ,肾小球硬化率、系膜增生程度、肾小管间质病变及肾小动脉病变程度均较重 ,血肌酐升高发生率也明显较高。结论 伴高血压的 Ig A肾病以中青年男性多见 ,临床表现以蛋白尿伴血尿为主 ,肾脏病变较重 。

Objective To explore the epidemiological and clinico pathological features of IgA nephropathy with hypertension. Methods The epidemical and clinico pathological data of IgA nephropathy with hypertension(HP group,214 cases) and without hypertension(N HP group,326 cases) were studied controlly and analysed. Results :In HP group, male was predominant , male:female was 2 6 3:1. The clinical manifestation were classified as proteinuria accompaned with hematuria (61.68%),proteinuria(23 83%),nephrotic syndrome accompaned with hematuria (8 88%),nephrotic syndrome(3 27%) and hematuria(2 34%).As compared with NHP group,HP group had more excretion of protein in urine ,lower level of plasma albumin ,higher level of triglycerid and cholesterol, higher level of serum creatinine.Not only the percentage of glomerular sclerosis and crescent formation were higher ,but also the degree of mesangial proliferation,renal interstitial change and renal arteriolar lesion were more serious in HP group than those in N HP group.The percentage of patients with abnormal level of serum creatinine in HP group was higher than that in N HP.Conclusion:This study suggusted male and adolescent are predominent in IgA nephropathy with hypertension.The most common clinical sydrome is proteinuria accompaned with hematuria.The renal pathological change might be more serious.The prognosis of IgA nephropathy with hypertension is poor.