Two Cases of ANCA-negative Pauci-immune Crescentic Glomerulonephritis in Pregnant or Maternal Women

Here two cases of renal failure occurring in pregnancy were reported,with biopsy-proven pauci-immune crescentic glomerulonephritis at postpartum.It is most rare that pauci-immune crescentic glomerulonephritis as the cause of renal failure in pregnancy.Their renal function could remain stable for some time due to timely and appropriate treatment.Therefore,the pregnant and maternal who have the performance of renal impairment should be closely tracked their blood pressure,urinary protein and renal function,if necessary,execute renal biopsy,for a clear and accurate pathological diagnosis is of great significance to grasp the opportunity of treatment.But the long-term prognosis is still poor.

Post-streptococcal acute glomerulonephritis in children:Association between proteinuria levels and renal outcomes

BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with significant long-term morbidity,and histological abnormalities such as crescentic glomerulonephritis are infrequently reported.PSAGN has also been linked to late-onset chronic kidney disease in some populations due to high levels of proteinuria.METHODS This prospective observational study was conducted at Lady Ridgeway Hospital(Colombo,Sri Lanka)over 15 months.Children with PSAGN were enrolled based on clinical and laboratory criteria.Persistent proteinuria≥2+for 2 weeks and serum creatinine>100μmol/L warranted renal biopsy,assessed via light microscopy and immunofluorescence.Normalization of complement 3(C3)within 6 to 8 weeks was required for inclusion.Data on clinical features,urine protein levels,and renal function were collected from patient records,and potential associations were analysed using Statistical Package for the Social Sciences and R language for statistical computing.Ethical approval was obtained from the Ethical Review Committee,Lady Ridgeway Hospital for Children(Ref No:LRH/ERC/2021/60).RESULTS Forty-four patients were recruited.There were 27(61.4%)male patients and 17(38.6%)female patients.Thirty-seven(84%)of them were above 5 years of age.Twenty(45%)patients had a history of skin sepsis,and eighteen(41%)had a history of throat infection.Among patients with proteinuria≥2+,53%had serum creatinine>100µmol/L,while among those with proteinuria<2+,7%had serum creatinine>100µmol/L.The association of high-degree proteinuria with elevated serum creatinine was significant(χ²=7.8,P=0.005)in PSAGN.The odds ratio of the logistic regression model was 1.049(95%confidence interval:1.003-1.098),indicating a positive direction with statistically significant association(P=0.037).There was no significant association between proteinuria and the degree of hypertension or estimated creatinine clearance.Ten children underwent renal biopsy.Crescents(less than 50%)were demonstrated in five children,while three children had typical diffuse proliferative glomer-ulonephritis.One child had severe acute tubular necrosis,and another had crescentic glomerulonephritis(crescents>50%).The immunofluorescence studies revealed deposition of immunoglobulin G and C3 in all biopsy specimens.CONCLUSION High-degree proteinuria was significantly associated with elevated serum creatinine(>100μmol/L)in children with PSAGN.The majority of children with persistent proteinuria≥2+for more than 2 weeks and the highest recorded serum creatinine>100μmol/L had atypical renal histological findings.

Antineutrophil cytoplasmic antibodies crescentic allograft glomerulonephritis after sofosbuvir therapy

Antineutrophil cytoplasmic antibodies(ANCA) are well known to be associated with several types of vasculitis, including pauci-immune crescentic glomerulonephritis, a form of rapid progressive glomerular nephritis(RPGN). ANCA vasculitis has also been reported after administration of propylthiouracil, hydralazine, cocaine(adulterated with levimasole), allopurinol, penicillamine and few other drugs. All previously reported cases of drug-associated ANCA glomerulonephritis were in native kidneys. Sofosbuvir is a new and effective drug for hepatitis C virus infection. Here, we report a case of ANCA vasculitis and RPGN following sofosbuvir administration in a kidney transplant recipient. It also represents the first case of drug-associated ANCA vasculitis in a transplanted kidney. Further drug monitoring is necessary to elucidate the degree of association and possible causal effect of sofosbuvir and perinuclear ANCA vasculitis.

The clinical and pathological characteristics of Chinese patients with pauci-immune crescent glomerulonephritis

目的 对寡免疫复合物型新月体肾炎进行临床病理分析。方法 采用病理检查包括 :光镜检查、免疫病理分析、血清学检查、肾功能检查以及统计学分析。结果 6 4 0 0例非移植肾活检中发现 2 4例寡免疫复合物型新月体肾炎 (PICGN)患者 ,占肾活检总数的 0 37% ,占新月体肾炎总数的 2 3 9% ,其中女性 16例 ,男性 8例 ,平均年龄 33岁。血管炎中微型多动脉炎 (33 3% )和结节性多动脉炎 (8 3% )为常见继发病因。抗中性粒细胞胞浆抗体 (ANCA)阳性率为 52 2 %。临床上多表现为急进性肾功能减退 (75 0 % ) ,发作性肉眼血尿发生率高 (58 3% ) ,高血压发生率为 4 5 8% ,肾病综合症发生率为 4 1 7% ,2 5%患者出现少尿无尿症状。除贫血外 ,肾外表现较少。病理上血管襻坏死 (6 2 5% )、单核及中性粒细胞浸润(6 6 7% )及小血管炎等为常见的急性病变 ;然而 ,小球硬化 (4 5 8% )、小管萎缩 (83 3% )、间质纤维化 (75 0 % )等慢性化病变也较严重。 2 2例患者行免疫抑制治疗 ,16例随访 8— 92个月 ,有 4例肾功能在正常范围 (<12 4 μmol/L) ,8例行非透析保守治疗 ,仅 4例进入终末期肾功能衰竭需进行维持性血透析治疗。结论 免疫抑制冲击治疗是治疗PICGN的有效方法。

C3 glomerulonephritis

A case of rapidly progressive glomerulonephritis with pathological changes to the crescent glomerulonephritis“C3 glomerulonephritis”in the Third Affiliated Hospital of Inner Mongolia Medical University was collected and its diagnosis,clinical manifestation,and pathological characteristics were explored.The experts analyzed the disease from the perspective of its causes,diagnosis,complications and treatment.Timely renal biopsy is required to clarify pathological diagnosis as the primary glomerular disease was newly recognized with a lower incidence.So misdiagnosis and delayed healing is more frequent.The paper aims to enhance the clinician’s understanding of“C3 glomerulonephritis”.

The distribution and significance of renal infiltrating cells in patients with diffuse crescentic glomerulonephritis

Objective To study the significance and distribution of renal infiltrating cells, including monocytes (CD68+ cells), proliferative cell nuclear antigen positive cells (PCNA+ cells), CD4+ and CD8+ cells in diffuse crescent glomerulonephritis (DCGN). Methods Fifty-six patients with DCGN were studied, including 10 cases of anti-glomerular basement membrane (GBM)-type Ⅰ DCGN, 26 immune complex-type Ⅱ DCGN, and 20 cases of pauci-immune-type Ⅲ DCGN. Glomerular and interstitial infiltrates of CD68+ and PCNA+ cells, and interstitial infiltrates of CD4+ and CD8+ cells were detected by using four-layer PAP methods. Results There was a significant increase of renal infiltrating CD68+, PCNA+, CD4+ and CD8+ cells in patients with DCGN compared with that in normal controls. In patients with type Ⅰ DCGN, there was a higher number of renal infiltrating CD68+ and PCNA+ cells than that in patients with type Ⅱ and Ⅲ DCGN. A glomerular infiltrates of CD68+ and PCNA+ cells correlated with the interstitial infiltrates of CD4+ cells in type Ⅰ or Ⅲ DCGN patients. In lupus DCGN patients, the numbers of renal infiltrating CD68+ and PCNA+ cells were similar to vasculitis or type Ⅲ DCGN patients.Conclusion These findings demonstrate that the renal infiltrates of CD68+ and PCNA+ cells play an important role in patients with DCGN, that the infiltrates of CD4+ cells correlate with the infiltrates of CD68+ and PCNA+ cells may be an active marker of DCGN, and that cell-mediated immunity may contribute to crescent formation in lupus DCGN patients.

Infective Endocarditis-induced Crescentic Glomerulonephritis Dramatically Improved after Removal of Vegetations and Valve Replacement

Infective endocarditis （IE） is associated with poor prognosis and higher mortality. IE-induced glomerulonephritis, especially crescentic glomerulonephritis （IE-CGN） with renal dysfunction, is an independent risk factor for mortality For the treatment of IE-CGN, many therapeutic strategies including antibiotics alone, antibiotics combined with corticosteroid, immunosuppressive agents, plasmapheresis, or cardiac surgery have been applied and obtained various results.C21 Here, we reported a case of CGN with progressive renal failure secondary to IE in which the renal function was dramatically improved by the treatment of surgical valve replacement and antibiotics.

Clinical spectrum of diffuse crescentic glomerulonephritis in Chinese patients

Objective To investigate retrospectively the incidence, distribution of primary disease and clinicopathologic characteristics of diffuse crescentic glomerulonephritis (DCGN) in Chinese patients.Methods One hundred and seventy-two consecutive patients diagnosed as having DCGN out of 9828 cases of non-transplanting renal biopsies over sixteen years, were studied. DCGN is categorized into three types according to immunopathologic characteristics. The incidence of this disease, its primary diseases, clinical characteristics and serum antineutrophil cytoplasmic antibodies (ANCAs) were analyzed.Results The distribution of patients among the three classifications was 8. 7% type Ⅰ , 68. 6% type Ⅱ and 22. 7% type Ⅲ. Clinically, the majority of patients (69.8%) presented rapidly progressive glomerulonephritis (RPGN), but 30. 2% manifested a chronic nephritic syndrome or chronic renal failure. In terms of related conditions, 93% were anemic, 61. 6% had hypertension, 50. 6% oliguria, 45.3% nephrotic syndrome, 43% uremic syndrome and 39.5% displayed gross hematuria. Those patients who were positive in serum for ANCAs had predominantly type Ⅲ DCGN. Two cases with anti-GBM-antibody crescentic glomerulonephritis and three with lupus nephritis were also positive for ANCAs in serum.Conclusion DCGN is not rare in Chinese patients. A majority of patients in our study presented with RPGN, but 30. 2% manifested a chronic renal failure. Lupus patients with DCGN that were positive for ANCAs had more severe vasculitic lesions.

Significance of anti neutrophil cytoplasmic antibodies in patients with pauci immune crescentic glomerulonephritis

Objective To evaluate the significance of serum anti neutrophil cytoplasmic antibodies (ANCAs) and the effects of immune suppressive treatments on its activity in patients with pauci immune crescentic glomerulonephritis (PICGN) Methods Serum ANCAs and myeloperoxidase (MPO) ANCA were detected by indirect immunofluorescence and enzyme linked immuno^sorbent assay (ELISA) methods respectively, and the renal tissues infiltrating cells including CD4 +, CD8 +, CD68 + and PCNA + cells were determined by four layer peroxidase antiperoxidase (PAP) method The clinical manifestations, pathologic features and immune pathologic changes in patients with positive ANCAs were compared with that in patients with negative ANCAs The effects of immune suppressive therapy on clinic and pathologic changes as well as ANCAs activity were also investigated in ANCAs positive and ANCAs negative patients Results Both of clinic active manifestations such as the degree of hematuria, rapidly progressive renal failure and pathologic active features including segmental capillary necrosis and vasculitis were much common in patients with positive ANCAs as compared with that in patients with negative ANCAs The number of infiltrating cells in renal tissue, especially CD4 + cells, was markedly higher in ANCAs positive patients than that in ANCAs negative patients The effects of immune suppressive therapy were also much better in patients with positive ANCAs than that in patients with negative ANCAs Conclusion Serum ANCAs is not only a marker for diagnosis of systemic vasculitis, but also a sensitive predictor for evaluation of diseases' activity and treatment in patients with PICGN The good effect of immune suppressive treatments on patients with PICGN is partially associated with the degree of ANCAs activity

表现为新月体性肾小球肾炎的纤维性肾小球病

34岁女性患者,临床表现为水肿、高血压、大量蛋白尿、镜下血尿、低蛋白血症、血清肌酐升高。肾活检病理光镜示大量新月体形成伴袢坏死,电镜示上皮下、基膜内及系膜区杂乱分布的纤维样结构(直径12~30 nm)沉积,肾小球免疫组化染色DNAJ热休克蛋白家族成员B9(DNAJB9)阳性,诊断为DNAJB9相关纤维性肾小球病、新月体性肾小球肾炎。给予利妥昔单抗、吗替麦考酚酯、糖皮质激素等治疗,获得了较好的临床疗效。

原发性IgA肾病伴弥漫性新月体形成的临床特点及预后分析

目的了解弥漫性新月体IgA肾病(CIgAN)患者的临床病理特征和预后。方法2007年7月至2022年7月经肾活检确诊为弥漫性新月体IgAN患者33例,分析临床及病理资料。随访时间超过6个月患者22例纳入随访队列。结果33例患者中男18例(55%),女15例(45%),肾活检时年龄为36(21.5,51)岁,血清肌酐(Scr)153(92,271)μmol/L,新月体百分比为62.5%(54.2%,66.7%),其中细胞纤维性新月体为(26.1%±16.5%)。13例患者有前驱呼吸道感染。22例患者平均随访时间为25(8,72)个月。10例(46%)患者进展至复合肾脏结局,其中8例(36%)发展为终末期肾脏病。多因素Cox回归结果显示,肾活检时Scr是复合肾脏结局的独立危险因素,而新月体的百分比与复合肾脏结局无关。受试者工作特征曲线结果表明,即使接受免疫抑制剂治疗,肾活检时Scr浓度大于149μmol/L的弥漫性新月体IgAN患者预后不良风险仍然较高。结论弥漫性新月体IgAN病情进展快,预后差,尤其是肾活检时Scr浓度大于149μmol/L的患者。新月体类型以细胞纤维性新月体为主。肾活检时血清Scr浓度是弥漫性新月体IgAN患者eGFR下降≥50%或ESKD的独立危险因素,而新月体的百分比与患者预后无明显相关性。

一波三折的非霍奇金淋巴瘤相关肾损害

目的分享并探讨诊断困难的非霍奇金淋巴瘤相关肾损害的诊疗经验。方法分享广州中医药大学第二附属医院2019年12月收治的1例非霍奇金淋巴瘤相关肾损害病人的诊疗经过和诊断过程。结果第1阶段,病人表现为肾病综合征,于外院行肾穿刺活检诊断为膜性肾病Ⅰ期、冷球蛋白血症肾损害待排。第2阶段,病人因急性肾损伤入住广州中医药大学第二附属医院,行肾穿刺活检诊断为膜性肾病Ⅱ期伴新月体肾小球肾炎。第3阶段,病人因左眼眶肿物,行活检后诊断为非霍奇金淋巴瘤。第4阶段,病人因腹膜炎入院,后病情缓解,摆脱血液透析和腹膜透析。随着化疗肿瘤及肾病的缓解,考虑非霍奇金淋巴瘤相关肾损害成立。结论最初诊断膜性肾病的中老年病人,需更频繁地进行恶性肿瘤筛查。

霉酚酸酯治疗Ⅲ型新月体肾炎(附3例报道)

目的：观察霉酚酸酯（ Ｍ Ｍ Ｆ） 治疗Ⅲ型新月体肾炎（ Ⅲ型 Ｃ Ｇ Ｎ） 的疗效。 方法：３ 例血清抗中性粒细胞抗体阴性，肾活检为Ⅲ型 Ｃ Ｇ Ｎ 患者，在甲基强的松龙冲击治疗后应用 Ｍ Ｍ Ｆ（１０ ｇ／ｄ） 治疗，观察 Ｍ Ｍ Ｆ 治疗后尿蛋白、血尿和肾功能变化，同时行重复肾活检观察肾组织学改变。 结果：３ 例患者治疗后肾脏损伤明显减轻，蛋白尿、血尿均显著减少，随访一年，２ 例患者肾功能恢复正常。治疗过程中病情平稳未出现严重副作用。重复肾活检均显示活动性病变显著改善，新月体、节段坏死、肾小球炎细胞浸润、间质血管炎消失或显著减少。一例伴肝硬化和糖尿病者应用 Ｍ Ｍ Ｆ 后也取得显著疗效，肝功能保持良好。 结论： Ｍ Ｍ Ｆ 有望在新月体肾炎的治疗上发挥独特的作用。

伴有新月体形成的IgA肾病的临床特征及预后

目的探讨伴有新月体形成的IgA肾病的临床特征及预后。方法分析89例伴新月体形成的IgA肾病患者肾活检时的临床资料,以412例无新月体IgA肾病患者为对照。对其中276例患者进行随访观察,了解患者人、肾存活情况,用非参数乘积限估计法(Kaplan-Meier法)分析肾存活率。结果新月体形成在IgA肾病中的发生率为17.8%,39例(43.9%)表现为急进性肾炎,明显高于不伴有新月体形成的IgA肾病患者。其肾小球、肾小管间质病变程度均较无新月体组重,并随着其形成范围及纤维性新月体增加而加重。新月体组平均随访(40.3±29.6)月,其1、3、5年肾存活率分别为95.24%、80.95%和61.9%;无新月体组平均随访(45.1±26.9)月,其1、3、5年肾存活率分别为100%、91.67%和79.17%。结论伴新月体形成的IgA肾病患者临床表现和病理表现较重,预后较差。

抗肾小球基膜抗体疾病的临床流行病学分析(附14例报告)

目的 :通过对抗肾小球基膜抗体疾病 (抗 GBM疾病 )病例的回顾性分析 ,为我国抗 GBM疾病的流行病学、临床及病理表现特征、治疗现状及预后等方面提供更多资料。 方法 :回顾性分析本所肾脏病临床中心在1980～ 2 0 0 0年间 14例经肾活检证实诊断为抗肾小球基膜抗体疾病患者的临床病理资料。 结果 :该 14例抗 GBM疾病患者占全部自体肾肾活检病例的 0 14 % ,占新月体肾炎的 9 1%。 14例患者中男性 13例 ,女性 1例 ,平均起病年龄为 ( 2 6 7± 8 1)岁 ,大多患者在冬春季节起病 ,10例于发病前一月内有呼吸道感染史。 14例患者均在起病时或短期内出现急进性肾功能衰竭 ,13例需肾脏替代治疗 ;8例病程中出现咯血 ,其中 6例以咯血起病 ;全部病例均伴有不同程度的贫血 ;1例患者伴有中枢神经系统受累。肾脏受累主要表现为肉眼血尿 ( 8/ 14 )、少尿 ( 10 / 14 )或无尿性肾功能衰竭 ( 3 / 14 )。起病时血清学检查抗 GBM抗体 (间接免疫荧光法 )阳性者 13例 (另一例在病程后期出现阳性 ) ,血清C3水平均正常 ,抗核抗体、抗双链DNA抗体及抗中性粒细胞胞浆抗体均阴性。病理上均出现大量新月体形成 ,其中 13 / 14表现为新月体肾炎 (新月体比例 >50 % ) ,8/ 14表现为 10 0 %的新月体肾炎 ,4例出现明显血管袢坏死改变。

激素及环磷酰胺冲击治疗对新月体肾炎肾小球趋化因子的影响

目的 :观察激素及环磷酰胺 (CTX)静脉冲击 ,对Ⅱ型和Ⅲ型新月体肾炎 (CGN)患者肾小球内浸润的CD6 8+ 细胞及单核细胞趋化蛋白 1(MCP 1)、巨噬细胞炎性蛋白 1α和β(MIP 1α、MIP 1β)表达的影响。 方法 :激素及CTX静脉冲击治疗 1至 3个月后进行重复肾活检的Ⅱ型和Ⅲ型CGN各 6例 ,应用免疫酶标方法检测肾小球内CD6 8、MCP 1、MIP 1α和MIP 1β的表达。 结果 :虽然激素及环磷酰胺静脉冲击治疗能够明显减少Ⅱ型和Ⅲ型CGN患者肾小球新月体数 ,其对肾小球中趋化因子表达的影响明显不同。①Ⅱ型CGN患者细胞性新月体的肾小球中CD6 8、MCP 1和MIP 1α的表达均较治疗前明显减少 ,有显著性差异 ,MIP 1β的表达也较治疗前有所下降 ,但无显著性差异 ;Ⅲ型CGN患者细胞性新月体的肾小球中CD6 8较治疗前明显下降 ,有显著性差异 ,而MCP 1、MIP 1α和MIP 1β较治疗前有所下降 ,但无显著性差异。②冲击治疗能够减少Ⅱ型和Ⅲ型CGN新月体总百分比和细胞性新月体的百分比 ,但重复肾活检时 ,Ⅲ型CGN肾小球硬化及小管间质纤维化程度明显高于Ⅱ型CGN。③比较 1个月和 2～3个月后进行重复肾活检的CGN组织病理的变化 ,发现治疗后 1个月 ,肾小球中CD6 8及MCP 1、MIP 1α和MIP 1β表达已明显下降 ,新月体总百分比及细胞性新月体?

儿童新月体性IgA肾病临床与病理分析

目的了解儿童原发性新月体性IgA肾病的临床、病理和免疫病理的特征.方法分析9例儿童原发性新月体性IgA肾病患儿的临床、病理和免疫病理资料,进行疗效观察及随访.结果临床表现为肾病综合征5例,急进性肾炎3例,无症状性血尿和蛋白尿1例.尿蛋白均＞2g/d,其中＞3 g/d者7例;有持续性肉眼血尿8例,其中＞2周者7例;肾功能减退者8例,其中5例仅内生肌酐清除率(CCr)轻度下降者;伴高血压7例.9例肾病理均有不同程度的弥漫性系膜增生和小管-间质病变,平均74.5%肾小球有新月体形成,半数病例可见球囊粘连、小球硬化、节段内皮增生和间质灶状纤维化.免疫荧光无1例单纯IgA型,IgA+M和IgA+M+G型占55.6%,4例呈'满堂亮'.8例经大剂量甲基泼尼松龙冲击2～4个疗程治疗,肉眼血尿、高血压全部消失,肾功能恢复正常,蛋白尿有不同程度改善.7例随访3～18个月,3例尿蛋白正常,2例轻度蛋白尿(＜1g/d),尿蛋白＞3 g/d者2例.结论本组儿童原发性新月体性IgA肾病临床以肾病综合征为主,持续性肉眼血尿和大量蛋白尿突出,肾功能减退程度不一;肾小球、小管和间质均有急、慢性病理改变,球囊粘连、小球硬化和间质纤维化易见,免疫病理以IgA合并IgM、IgG沉积为主,可见'满堂亮'现象.及时大剂量甲基泼尼松龙冲击治疗,短期疗效好.

膜性肾病合并抗中性粒细胞胞质抗体相关性新月体肾炎

抗中性粒细胞胞质抗体（anti-neutrophil cytoplasm antibody,ANCA）相关性血管炎常以急进性肾炎综合征起病,ANCA阳性,肾脏多表现为寡免疫复合物沉积的坏死性新月体肾炎,即ANCA相关性新月体肾炎,因其病变进展快,累及多系统,是肾脏疾病的危急重症.ANCA相关性新月体肾炎若存在明显的免疫复合物沉积（荧光强度〉2＋）,可能代表并存其他疾病,如IgA肾病、感染后肾炎或膜性肾病（membranous nephropathy,MN）等.

老年特发性膜性肾病合并新月体坏死性肾小球肾炎的临床特点

目的探讨特发性膜性肾病(IMN)合并新月体坏死性肾小球肾炎的诊断思路及肾病理与预后的关系。方法 5例IMN合并新月体坏死性肾小球肾炎经肾病理确诊,分析实验室指标和肾病理特点。结果 5例患者4例为男性,1例为女性,平均年龄65岁,均伴肾外症状,血清抗中性粒细胞胞浆抗体(ANCA)阳性,呈重度蛋白尿、低白蛋白血症和不同程度的肾功能减退。肾病理示5例均有不同程度的新月体形成和坏死病变;电镜显示1例为Ⅰ~Ⅱ期膜性肾病,3例为Ⅱ~Ⅲ期膜性肾病,1例为Ⅲ期膜性肾病。经免疫抑制治疗1例病情好转,其余4例无缓解。结论肾病理对于确诊具有重要意义,预后可能与新月体形成的程度和IMN的电镜分期相关,免疫抑制治疗仅对轻症患者有效。

伴新月体形成的青壮年原发性IgA肾病临床病理特征分析

目的分析青壮年原发性IgA肾病伴新月体形成的临床及病理特征。方法选取124例经肾活检确诊为原发性IgA肾病并伴新月体形成的青壮年患者,年龄20～40岁,按新月体占受累小球比例分为2组:A组48例和B组76例。按Katafuchi积分描述病理特征。结果 1)预后:A组24 h尿蛋白定量、尿酸显著高于B组,eGFR、白蛋白显著低于B组,2组比较差异有统计学意义(P<0.05);而血压、肌酐、血脂、血糖、血清IgA、血清C3及IgA/C3比值2组之间差异无统计学意义(P>0.05)。2)病理:2组肾小球、肾小管积分比较差异均有统计学意义(P<0.05)。结论青壮年患者随着新月体占受累小球比例的增加,临床预后渐趋严重,肾小管间质病理损害亦逐渐加重,临床应积极对青壮年伴新月体形成的IgA肾病患者进行干预治疗,以延缓病情进展。