国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
INTERNATIONAL JOURNAL OF UROLOGY AND NEPHROLOGY
2011年
5期
586-589
,共4页
王玉新%玄先法%邹和群%黄海望%曹建南%张以勤%朱璇%叶婧%吕天羽
王玉新%玄先法%鄒和群%黃海望%曹建南%張以勤%硃璇%葉婧%呂天羽
왕옥신%현선법%추화군%황해망%조건남%장이근%주선%협청%려천우
肾小球肾炎%IGA
腎小毬腎炎%IGA
신소구신염%IGA
Glomerulonephritis%IGA
目的 探讨原发性IgA肾病患者的临床表现、病理特点及其相关性。方法 回顾性总结分析本院1999年1月至2010年6月经肾活检确诊为原发性IgA肾病的210例患者的临床表现及病理特点。结果 506例肾活检患者中IgA肾病210例，检出率为41.5％。患者平均年龄为28.9±10.3岁，以20 ～ 39岁为高发，占59.5％ (125/210)。其临床表现多样化，非大量蛋白尿伴水肿和（或）高血压者最多，为83例(39.5％)；其次为大量蛋白尿表现为肾病综合征者57例(27.1％)；血肌酐升高表现为慢性肾衰竭者24例(11.4％)。病理上包括多种原发性肾小球疾病的病理类型，以局灶节段增生型或弥漫系膜增生型最为常见，分别为27.6％ (58/210)、23.3％ (49/210)。免疫病理方面IgA强度以++最为常见，约占35.2％，+++次之，约占31.4％。单纯IgA阳性者占13.3％ (28/210)；合并IgG沉积者13例(6.2％)；95例患者合并IgM的沉积(45.2％)；合并补体C3沉积者最为多见，占80.5％ (169/210)。结论IgA肾病在中青年发病率高，危害性较大。其临床表现及病理改变多种多样，且两者不完全相一致。临床疑是IgA肾病患者建议尽早肾活检以明确诊断、积极治疗，阻止或延缓慢性肾脏病进展。
目的 探討原髮性IgA腎病患者的臨床錶現、病理特點及其相關性。方法 迴顧性總結分析本院1999年1月至2010年6月經腎活檢確診為原髮性IgA腎病的210例患者的臨床錶現及病理特點。結果 506例腎活檢患者中IgA腎病210例，檢齣率為41.5％。患者平均年齡為28.9±10.3歲，以20 ～ 39歲為高髮，佔59.5％ (125/210)。其臨床錶現多樣化，非大量蛋白尿伴水腫和（或）高血壓者最多，為83例(39.5％)；其次為大量蛋白尿錶現為腎病綜閤徵者57例(27.1％)；血肌酐升高錶現為慢性腎衰竭者24例(11.4％)。病理上包括多種原髮性腎小毬疾病的病理類型，以跼竈節段增生型或瀰漫繫膜增生型最為常見，分彆為27.6％ (58/210)、23.3％ (49/210)。免疫病理方麵IgA彊度以++最為常見，約佔35.2％，+++次之，約佔31.4％。單純IgA暘性者佔13.3％ (28/210)；閤併IgG沉積者13例(6.2％)；95例患者閤併IgM的沉積(45.2％)；閤併補體C3沉積者最為多見，佔80.5％ (169/210)。結論IgA腎病在中青年髮病率高，危害性較大。其臨床錶現及病理改變多種多樣，且兩者不完全相一緻。臨床疑是IgA腎病患者建議儘早腎活檢以明確診斷、積極治療，阻止或延緩慢性腎髒病進展。
목적 탐토원발성IgA신병환자적림상표현、병리특점급기상관성。방법 회고성총결분석본원1999년1월지2010년6월경신활검학진위원발성IgA신병적210례환자적림상표현급병리특점。결과 506례신활검환자중IgA신병210례，검출솔위41.5％。환자평균년령위28.9±10.3세，이20 ～ 39세위고발，점59.5％ (125/210)。기림상표현다양화，비대량단백뇨반수종화（혹）고혈압자최다，위83례(39.5％)；기차위대량단백뇨표현위신병종합정자57례(27.1％)；혈기항승고표현위만성신쇠갈자24례(11.4％)。병리상포괄다충원발성신소구질병적병리류형，이국조절단증생형혹미만계막증생형최위상견，분별위27.6％ (58/210)、23.3％ (49/210)。면역병리방면IgA강도이++최위상견，약점35.2％，+++차지，약점31.4％。단순IgA양성자점13.3％ (28/210)；합병IgG침적자13례(6.2％)；95례환자합병IgM적침적(45.2％)；합병보체C3침적자최위다견，점80.5％ (169/210)。결론IgA신병재중청년발병솔고，위해성교대。기림상표현급병리개변다충다양，차량자불완전상일치。림상의시IgA신병환자건의진조신활검이명학진단、적겁치료，조지혹연완만성신장병진전。
Objectives To study the clinical manifestation, pathological features and their correlation in patients with idiopathic IgA nephropathy( IgAN). Methods The clinicopathological data of 210 biopsy - proven cases of IgAN from Jan. 1999 to Jun. 2010 in our hospital were retrospectively analyzed. All the patients exclude secondary IgAN such as lupus nephritis, purpura nephritis, sjogren syndrome, HBV -associated glomerulonephritis.Results There were 210 patients with IgAN in 506 patients who accepted renal biopsy and the frequency of IgAN was 41.5％. 56.2％ patients were male and 43.8 ％ female. The average age of the patients was 28.9 ± 10.3 years old. The incidence of IgAN was the highest in patients at the age of 20 ～ 29 years(59.5％ ). Clinically, chronic nephritis syndrome type was the most common clinical manifestation(39.5％ ,83/210) ,followed by nephritic syndrome (27. 1％ ,57/210) , chronic renal failure( 11.4％ ) ,gross hematuria( 10.9％ ) and latent glomerulonephritis ( 10.9％ ). The pathological types of IgAN included various pathological types of primary glomerular disease. The frequency of focal proliferative type (27.6％ ,58/210) was higher than those of diffuse proliferative type (23.3 ％ ,49/210 ), minor lesion type ( 15.7％, 33/210 ), and early sclerotic type ( 13.8 ％ , 29/210). The IgA fluorescence intensity of + + was the most common seen in IgAN, accounting for 35.2％ and + + + was the next in order, accounting for 31.4％. Immunopathological results showed that merely staining of IgA in mesangial area was in 28 patients, accounting for13.3％. Staining of IgA combined with 1gG was in 6.2％ of 210 patients. Staining of IgA combined with 1gM was in 45.2％. 169 patients had C3 deposit, accounting for 80.5％. Conclusions The high incidence of IgAN occurs on the period of youngs. IgAN has diverse clinical manifestation and pathological changes,the former didnt correspond with the latter completely. The prognosis is associated with pathological changes closely.Early renal biopsy should be performed in the patients who are doubted to be IgAN and appropriate therapy administered according to the pathological features in order to put off the development of chronic kidney diseases.
