IgA肾病的临床病理特征及激素疗效观察

Clinical pathological characteristics and hormone therapeutic effect of IgAN （IgA nephropathy）

【目的】探讨IgA肾病（IgAN）的临床病理特征及激素疗效。【方法】选取在本院治疗的经肾组织活检确诊的IgAN患者74例，比较患者治疗前后各时间点相关指标的变化，临床疗效及与病理参数的关系。【结果】患者在治疗后1个月，3个月，治疗后6个月，蛋白尿均低于治疗前，白蛋白定量均高于治疗前，患者的血尿素氮在治疗后3个月，6个月均高于治疗前，且差异具有显著性（P〈0．05）。患者治疗后痊愈19例，占25．68％，显效32例，占43．24％，有效14例，占18．92％。患者在轻度系膜增生型、中度系膜增生型、重度系膜增生型IgAN中、在不同肾小管损伤程度中的疗效相比较差异具有显著性（P〈0．05）。患者的治疗疗效与光镜病理分期呈正相关（r=0．280，P=0．010）。【结论]IgAN经激素治疗后的疗效显著，且疗效与一些病理参数存在着一定程度的关联。

[Objective]To Investigate the Clinical Pathological Characteristics and Hormone Therapeutic Effects of IgAN [Methods]74 cases of IgA nephropathy diagnosed by renal biopsy in our hospital were selected for this experiment. A comparison was made regarding urinary protein, blood urea nitrogen, serum creatinine, creatinine, albumin, ALT, and AST at different time point before and after treatment. These levels were com- pared with the relationship between therapeutic effects and pathological parameters. Correlation analysis be- tween therapeutic effects and pathological stages were made using a light microscope. [Results]The proteinuria of the study at 1 month, 3 months, and 6 months after treatment were significantly lower than before treat- ment （ P 〈0.05）. Blood urea nitrogen in the study at 3 months and 6 months after treatment were significant- ly higher than before treatment（ P 〈0.05）. The serum albumin levels in the study at 1 month and 6 months after treatment were higher than before treatment, and the difference was statistically significant （ P 〈0.05）. 19 cases （25.68 % ） were cured after treatment, markedly improved the circumstances in 32 cases （43.24 % ）, and effective in 14 cases （18.92%）.The difference of therapeutic efficacy of the study in the treatment of mild mesangial hyperplasia, moderate mesangial hyperplasia, severe mesangial proliferative IgAN, and the differ ence in the degree of renal tubular atrophy was statistically significant （ P 〈0.05）. The curative effects of the research object was positively correlated with the pathologic stage of the light microscope （ r=0.280, P = 0.010）. [Conclusion]IgA nephropathy has a significant effect on the treatment of hormone therapy, and the curative effects are related to some pathological parameters.