摘要
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。
Objective To understand the clinical features and prognosis of IgA nephropathy （IgAN） patients with glomeruar crescents. Methods The clinical data collected at the time of renal biopsy and the follow-up data of 89 IgAN patients with glomerular crescents were analyzed with 412 IgAN patients without crescents serving as the control group. Follow-up study was conducted in 78 patients with crescents and 198 without it, and the renal survival rate was estimated using Kaplan-Meier survival analysis. Results The incidence ofglomerular crescents was 17.8% in IgAN patients. Clinically, 39 patients with crescents experienced rapidly progressive glomerulonephritis, resulting in a significantly higher rate of this manifestation than that in patients without crescent. Patients with crescents also had more grave pathological changes in the glomerulus and renal tubule interstitium than the control patients. Patients were followed up for an average of 40.3±29.6 months in crescent group and 45.1±26.9 months in the control group, and the 1-, 3-, 5-year renal survival rate was 95.24%, 80.95%, 61.9% in the former and 100%, 91.67%, 79.17% in the latter, respectively. Conclusion IgAN patients with crescents have severer clinical and pathological manifestations and poorer prognosis than those without crescents.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2007年第3期336-339,共4页
Journal of Southern Medical University
关键词
肾小球肾炎
IGA
新月体
肾存活率
预后
glomerulonephritis, IgA
glomerular crescents
renal survival rate
prognosis
