摘要
目的研究IgA肾病(IgAN)临床特征和病理分级的关系,指导临床治疗并判断预后。方法回顾性总结经皮肾穿刺确诊为IgAN的160例患者,根据Lee分级,系统分析病理分级与临床指标之间的关系。结果肾脏病理Lee分级以Ⅱ、Ⅲ级为主,而I、Ⅳ、V级所占比例小。Lee分级高者高血压的发生率高,肾小球滤过率(GFR)下降明显。Lee分级情况与24h尿蛋白定量(TPU)间未发现必然联系。肉眼血尿型与尿检异常型Lee分级多为Ⅰ-Ⅲ级。肾功能衰竭型Lee分级多为Ⅳ、Ⅴ级。肾病综合征型Lee分级覆盖Ⅰ-Ⅴ级,但以Ⅱ、Ⅲ级为主。结论高血压、GFR下降明显的IgAN病理改变重,预后差。Lee分级与临床分型存在关联。
Objective The clarification of the correlation between clinical and pathological classification of IgA nephropathy （IgAN） will benefit the patients with IgAN on therapy and prognosis. Methods Renal biopsy by rapid percutaneous puncturation was performed on 160 patients with IgAN. All patients were divided into groups according to pathology indexes （Lee classification）. Here we reviewed the relationship between Lee classification and clinical indexes. Results For all the patients,Grade II and III were the major part in Lee classification,while Grade I, IV and V took only a small part. The patients with higher Grade showed higher incidence of high blood pressure with lower glomerular filtration rates （GFR）. There was no significant correlation between Lee classification and urine protein. Patients with clinical macroscopic hematuria or urinalysis abnormality were largely found in Grade I to III. Patients with kidney failure were mostly in Grade IV to V. IgA patients with nephritic syndrome covered Grade I to V, but mainly in II to III. Conclusions IgAN patients with high blood pressure and evident GFR descent show graver pathology damage and poorer prognosis. There was clinical significant between clinical manifestation and Lee classification.
出处
《中国临床保健杂志》
CAS
2009年第5期477-479,共3页
Chinese Journal of Clinical Healthcare
关键词
肾小球肾炎
IGA
症状和体征
病理过程
蛋白尿
预后
Glomerulonephritis
IGA
Symptoms ＆amp
signs
Pathologic processes
Proteinuria
Prognosis
