表现为小量蛋白尿IgA肾病临床及牛津病理分型研究

Study of clinical and pathological feature in primary IgA nephropathy patients with minimal proteinuria

目的探讨表现为小量蛋白尿IgA肾病患者临床表现及牛津病理分型特点。方法 80例经肾穿刺活检诊断原发性IgA肾病患者根据其24 h尿蛋白定量结果分为尿蛋白≤500 mg/24 h;500~1000 mg/24 h;>1000 mg/24 h三组,进行临床及病理资料回顾性分析。结果临床特点中尿蛋白量与高血压的发生具有相关性(P<0.05);临床指标中尿蛋白量与估算肾小球率过滤(eGFR)、血浆白蛋白、血红蛋白之间存在相关性(P<0.05);牛津病理分型中各指标与尿蛋白量之间差异无统计学意义。结论对于尿蛋白≤500 mg/24 h原发性IgA肾病患者的评估尚须进一步明确,对500~1 000 mg/24 h需加以重视、强调积极的肾活检及临床干预。

Objective To analyse the clinical manifestations and Oxford pathological grading in IgA nephropathy patients with mini-mal proteinuria.Methods The clinical and pathological material of 80 cases of IgA nephropathy patients from this hospital was retrospective-ly analysed,and the patients were divided into 3 groups according to the 24 h urine protein quantitative results:proteinuria:≤500 mg/24 h, 500~1 000 mg/24 h,and>1 000 mg/24 h.Results The proteinuria was related with hypertension(P<0.05).As for the clinical indexes, there was difference among proteinuria with estimated glomerular filtration rate(eGFR),albumin and hemoglobin(P<0.05).As for the path-ological grading,there was no significant difference.Conclusion More studies are needed to evaluate IgA nephropathy with proteinuria≤500 mg/24 h;and clinicians should strengthen the monitoring of the related indicators of the patients with proteinuria 500~1 000 mg/24 h to con-trol the disease.