摘要
探讨不同程度蛋白尿及伴有肉眼血尿IgA肾病的临床病理特点。方法:分析161例经肾活检确诊IgA肾病患者的临床和病理特点,根据尿蛋白量分为A组(≥2.0g/24h),36例,B组(<2.0g/24h),125例。将伴有肉眼血尿的患者44例,列入甲组,其余117例列入乙组。按Lee氏分级标准将肾脏的病理改变分级,采用Katafuchi的半定量标准作肾小球、肾小管间质、肾血管病变评分,对A、B组和甲、乙组进行比较。结果:A组血白蛋白(ALB)明显低于B组(P<0.01),血红蛋白(Hb)低于B组(P<0.05)。肾小球总分、肾球性硬化、肾小管总分明显高于B组(P<0.01),肾血管总分高于B组(P<0.05),A组的病理分级明显高于B组(P<0.01)。甲组较年轻(P<0.05),收缩压、舒张压低于乙组,(P<0.01、P<0.05),病理总分、肾小球总分、肾血管总分低于乙组(P<0.05)。结论:蛋白尿可加重小球硬化、节段损害及小管间质损害,是IgA肾病慢性进展重要因素之一,小管间质损害可使血红蛋白下降;伴有肉眼血尿者血压水平、肾脏血管病变程度较低,预后相对较好。
Objective To explore the clinical pathological features in lgA nephropathy（IgAN） patients with different degrees of proteinuria and macroscopic hematuria. Methods 161 IgAN patients diagnosed by renal biopsy were divided into group A（ n = 36 ,the amount of proteinuria≥2.0g/d） and group B（ n = 125, the amount of proteinuria 〈 2.0g/d）. The patients with macroscopic hematuria were divided into group one（n =44） and group two（n = 117）. The pathological changes were graded by the Lee,s criteria. The scores of glomerular,tubular - interstitial and vessels by Katafuchi half - quantitative criteria between group A and group B, group one and group two were compared, respectively. Results The ALB and hemoglobin were significantly lower in group A than those in group B（ P 〈 0.01, P 〈 0.05 respectively）. The scores of glomerular,glomerular sclerosis,the scores of tubular,pathological grades and the scores of vessels were significantly higher in group A than those in group B（ P 〈 0.01, P 〈 0.05 respectively）. The patients in group one were younger and with relatively lower hypertension than those in group two（ P 〈 0.01, P 〈 0.05 respectively） ,while the total pathological scores,the total scores of glomerular and the total scores of vessels lesions were lower than those in group two（ P 〈 0.05 ）. Conclusions Proteinuria can aggravate glomerular sclerosis and tubular interstitial injury. Tubular interstitial injury can reduce the hemoglobin level. The patients with macroscopic hematuria had relatively lower hypertension,lighter vessels lesions and good prognosis.
出处
《攀枝花学院学报》
2007年第3期89-92,共4页
Journal of Panzhihua University
关键词
蛋白尿
IGA肾病
肉眼血尿
IgA nephropathy
proteinuria
macroscopic hematuria
