蛋白尿与IgA肾病小管间质病理损害的关系研究

Relationship between Proteinuria and Tubulointerstitial lesions in Patients with IgA Nephropathy

目的 :探讨蛋白尿对IgA肾病(IgAN)的影响。方法 :经病理确诊为IgAN患者31例 ,以尿蛋白3.5g/24h为界分为大量蛋白尿组 (14例 )及少量蛋白尿组 (17例 )。小管间质病理损害分为轻微受损和明显受损。测定并比较2组肾小球及肾小管功能 ,系膜增生及肾小管间质病理损害程度。结果 :2组肾小球及肾小管功能指标均在正常范围 ,组间比较无显著性差异。轻度系膜增生情况亦无显著性差异 (P>0.05)。大量蛋白尿组肾小管间质病理损害明显 ,组间比较有非常显著性差异 (P<0.01)。结论 :蛋白尿可能是IgAN肾小管间质损害的重要因素。对大量蛋白尿的IgAN患者应给予积极有效的治疗。

Objective:To investigate the relationship between proteinuria and tubulointerstitial lesions in paˉtients with IgA nephropathy(IgAN).Methods:According to the boundary line of3.5g/24h,31IgAN patients diagnosed by renal biopsy were divided into an intense proteinuria group(groups A)(n=14)and a minimal proteinuria group(group B)(n=17).Their tubulointerstitial lesions,glomerular and tubular finctions were measured.Results:The glomerular and tubular functions were normal and the degrees of pathological lesion in glomerulus were similar in the two groups.There was no significant difference between them(P>0.05).The obvious lesions in tubulointerstitum in the group A were more than those in the group B(P<0.01).Concluˉsion:The proteinuria may be an important harmful factor to the tubulointerstitum of the patients with IgAN,and the treatment should be given to the patients with large amounts of proteinuria as soon as possible.