中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2010年
5期
329-331
,共3页
陈静%陈意志%赵学智%崔勇
陳靜%陳意誌%趙學智%崔勇
진정%진의지%조학지%최용
干燥综合征%肾小球肾炎,IgA%临床病理特征
榦燥綜閤徵%腎小毬腎炎,IgA%臨床病理特徵
간조종합정%신소구신염,IgA%림상병리특정
Sj(o)gren's syndrome%Glomerulonephritis,IgA%Characteristic of clinicopathologic
目的 分析继发于原发性干燥综合征(pSS)的IgA肾病患者的临床和肾脏病理特点,以提高对此类疾病的认识.方法 回顾性分析上海长征医院2004年12月至2009年8月8例继发于pSS的IgA肾病的临床和肾脏病理特点.结果 8例患者中男性1例,女性7例,平均年龄(44±8)岁.5例临床表现为水肿和蛋白尿,其中8例为镜下血尿,2例表现为反复血尿合并蛋白尿.尿蛋自定量(24 h)平均为(3±4)g.2例患者的肌酐水平超出正常值.光镜下,3例患者呈轻度系膜细胞增生,IgA肾病Lee氏分级均为Ⅰ级;5例患者肾小球发生全球硬化,Lee氏分级分别为Ⅱ、Ⅲ、Ⅳ级.免疫荧光检查,8例患者的肾小球系膜区可见以IgA为主的多克隆免疫球蛋白及补体的沉积.3例呈现"满堂亮".结论 在肾小球免疫复合物沉积方面,继发于pSS的IgA肾病不但有IgA免疫球蛋白的沉积,还有其他免疫球蛋白及补体的沉积,同原发性IgA肾病有明显差异.
目的 分析繼髮于原髮性榦燥綜閤徵(pSS)的IgA腎病患者的臨床和腎髒病理特點,以提高對此類疾病的認識.方法 迴顧性分析上海長徵醫院2004年12月至2009年8月8例繼髮于pSS的IgA腎病的臨床和腎髒病理特點.結果 8例患者中男性1例,女性7例,平均年齡(44±8)歲.5例臨床錶現為水腫和蛋白尿,其中8例為鏡下血尿,2例錶現為反複血尿閤併蛋白尿.尿蛋自定量(24 h)平均為(3±4)g.2例患者的肌酐水平超齣正常值.光鏡下,3例患者呈輕度繫膜細胞增生,IgA腎病Lee氏分級均為Ⅰ級;5例患者腎小毬髮生全毬硬化,Lee氏分級分彆為Ⅱ、Ⅲ、Ⅳ級.免疫熒光檢查,8例患者的腎小毬繫膜區可見以IgA為主的多剋隆免疫毬蛋白及補體的沉積.3例呈現"滿堂亮".結論 在腎小毬免疫複閤物沉積方麵,繼髮于pSS的IgA腎病不但有IgA免疫毬蛋白的沉積,還有其他免疫毬蛋白及補體的沉積,同原髮性IgA腎病有明顯差異.
목적 분석계발우원발성간조종합정(pSS)적IgA신병환자적림상화신장병리특점,이제고대차류질병적인식.방법 회고성분석상해장정의원2004년12월지2009년8월8례계발우pSS적IgA신병적림상화신장병리특점.결과 8례환자중남성1례,녀성7례,평균년령(44±8)세.5례림상표현위수종화단백뇨,기중8례위경하혈뇨,2례표현위반복혈뇨합병단백뇨.뇨단자정량(24 h)평균위(3±4)g.2례환자적기항수평초출정상치.광경하,3례환자정경도계막세포증생,IgA신병Lee씨분급균위Ⅰ급;5례환자신소구발생전구경화,Lee씨분급분별위Ⅱ、Ⅲ、Ⅳ급.면역형광검사,8례환자적신소구계막구가견이IgA위주적다극륭면역구단백급보체적침적.3례정현"만당량".결론 재신소구면역복합물침적방면,계발우pSS적IgA신병불단유IgA면역구단백적침적,환유기타면역구단백급보체적침적,동원발성IgA신병유명현차이.
Objective To analyze the clinical and pathologieal characteristics of IgA nephmlogy secondary to primary sj(o)gren's syndrome(pSS).Method The clinical and pathological data of 8 patients with pSS and IgA in Changzheng Hospital from 2004 to 2009 were analyzed.Results The average age of seven female and one male was (44±8) years old.Five patients presented with edema and proteinuria.Eight patients presented with microhematuria.The average 24-hour proteinuria was (3±4) g.Two patients had hypertension.Serum creatinine levels of two patients were higher than normal level,the others'were normal.Light microscopy examination showed three patients were mild mesangial proliferation with Lee's classification grade Ⅰ;five patients had global sclerosis with Lee's classification grade Ⅱ,Ⅲ and Ⅳ.Positive IgA was mainly found under immunofluorescence microscopy.Electronic microscopy showed no electron-dense deposits.Conclusion IgA nephrology secondary to pSS is different from primary IgA nephrology under immunofluorescence microscopy.
