IgA肾病小管间质损害的临床与病理研究

Clinical and Pathologic Study of Tubulointerstitial Lesions in IgA Nephropathy

目的 :探讨肾小管间质损害在IgA肾病的临床重要性。方法 :分析 2 0 1例IgA肾病的临床与病理资料。结果 :IgA肾病伴有肾小管间质损害占 86 1 % ,其中轻度损害占 4 7 3% ,中度损害占 2 1 9% ,重度损害占 1 6 9% ,无损害占 1 3 9%。血压升高、尿蛋白定量增多及肾功能减退是IgA肾病预后不良的临床因素。肾小球各项病理指标 :血管损害、肾小球总体损害、系膜增殖程度及球性硬化的积分随着肾小管间质的损害程度增加 ,二者呈平行关系。结论 :肾小管间质损害在IgA肾病病理改变中广泛存在。随着其损害程度的加重 ,IgA肾病的病情逐渐加重 ,提示肾小管间质损害是决定IgA肾病预后不良的关键因素之一。

Objective:To analyze the importance of tubulointerstitial lesions(TIL)in IgA Nephropathy(IgAN).Methods:The pathologic and clinical materials of 201 IgAN patients were analyzed.Results:The patients of TIL were about 86.1% in IgAN,these with mild TIL accounted for 47.3%,moderate TIL 21.9%,severe TIL was about 16.9% and these without TIL 13.9%.The relationship between TIL and the pathologic findingsis:with increase of the severity of TIL,the scores of vascular lesion,total glomerular lesion,hypercellularity and glomeruloselerosis increased gradually.Conclusion:With the increase of the severity of TIL,the condition of IgAN patients became worse.TIL may be one of the key factors for the prognosis of IgAN.