摘要
目的探讨表现为肾病综合征(肾综)的IgA肾病病理特性及其与预后关系.方法分析1987～2002年中山大学附属第一医院肾内科确诊的IgA肾病723例,表现为肾综的IgA肾病的临床、病理特征及疗效,与非肾综IgA肾病进行比较并长期随访.结果 7.1%(51/723)IgA肾病表现为肾综.肾综组高血压和肾功能不全发生率显著高于非肾综组(35.3%对13.8%和47.1%对19.2%,P<0.05);而肾小球指数和新月体指数均显著高于非肾综组(P<0.05).IgA肾综组存活率显著低于无肾综组(P<0.01),1、3、5年肾存活率分别为100.0%、84.9%、68.6%和100.0%、95.9%、91.9%(P<0.05).64%(7/11)Lee氏Ⅰ～Ⅱ级的肾综对激素敏感.结论呈肾综的IgA肾病病理损害较重,预后差,但有少数病理病变轻微,可能对激素敏感.
Objective To study the pathological characteristics and outcomes of IgA nephropathy （IgAN） presented with nephrotic syndrome （NS） and its relationship with prognosis, Methods From 1987 to 2002, clinical and pathological characteristics of IgAN presented with NS and its response to glucocorticoids therapy were reviewed and compared to non- nephrotic group. Results 7.1% （51/723） of IgAN presented as NS. The prevalence of hypertension and renal insufficiency was significantly higher in nephrotic group than that of non- nephrotic group （35.3% vs 13.8% and 47.1% vs 19.2 %, P 〈 0.05）. The glomerular and crescentic indexes were significantly higher in nephrotic group than that of non- nephrotic group （ P 〈 0.05）. The renal survival of nephrotic group was significantly lower than that of non- nephrotic group （ P 〈0.01）, The 1 -, 3 - and 5- year renal survival was 100.0%, 84.9%,68.6% and 100.0%, 95.9%, 91.9%, respectivdy （ P 〈0.01）. Sixty- four percents （7/11） of NS of Lee＇ s grading Ⅰ～Ⅱ responded to corticosteroid. Condusion IgAN presented with NS usually has significant pathological lesions and worse prognosis with the exception of a subgroup of minimal glomerular lesion, which may respond to steroid therapy.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2005年第8期722-724,共3页
Chinese Journal of Practical Internal Medicine
基金
教育部高等学校全国优秀博士学位论文作者专项资金(199945)
广东省科委自然科学基金(990075)
广东省科委重点科研基金(99B06705G)
广东省教育厅"千
百
十工程"人才基金(Q校02011)
关键词
IGA肾病
预后
病理
蛋白尿
IgA nephropathy Prognosis Pathology Proteinuria
