摘要
目的探讨IgA肾病患者的临床表现与牛津病理分型的相关性。方法分析192例IgA肾病患者的临床表现（年龄、性别、病程、血压、血尿、24h尿蛋白定量、血肌酐、血清白蛋白、甘油三酯、胆固醇、估计肾小球滤过率（eGFR））与病理资料（系膜细胞增生、内皮细胞增生、节段硬化或粘连、肾小管萎缩或间质纤维化、小动脉积分、细胞或细胞纤维新月体）的相关性。结果（1）192例IgA肾病患者临床表现以蛋白尿合并血尿最多见，为72例（37．5％），依次为肾病综合征42例（21．9％），肾功能不全29例（15．1％），合并高血压72例（37．5％）；（2）牛津病理分型中M1占60．0％，E1占55．2％，S1占46．9％，TO、T1、T2分别占59．9％、22．9％、17．2％，46．9％的患者存在小动脉内膜增厚，48．5％存在细胞或细胞纤维新月体，部分病理类型与年龄有关（P〈0．01）；（3）尿蛋白定量与系膜细胞增生、肾小管萎缩或间质纤维化、细胞或细胞纤维新月体有关（P〈0．01或P〈0．05）。血压、肾功与节段硬化或粘连、肾小管萎缩或间质纤维化、小动脉内膜增厚、细胞或细胞纤维月体有关（P〈0．01或P〈0．05）。结论牛津病理分型对IgA肾病的治疗和预后评价有很好的指导作用。
Objective To investigate the relationship of the clinical characteristics and the Oxford classification of IgA nephropathy. Methods Clinical presentation （ age, gender, course of disease , blood pressure, hematuria, 24-hour proteinuria, serum creatinine, serum albumin, triglyceride, cholesterol, and estimated glomerular filtration rate （ eGFR ） ）, pathological data （ mesangial hypercellularity, endocapillary hypercellularity , segmental sclerosis or adhesions, tubular atrophy or interstitial fibrosis, artery score, and cellular ＋ fiberocellular crescents） and their correlation of 192 patients with IgA nephropathy patients were analyzed. Results （1）Clinically, hematuria ＋ albuminuria type was the most common among 192 the pa- tients with IgA nephropathy （72 cases, 37. 5% ） followed by nephrotic syndrome （42 cases, 21.9% ） , renal insufficiency （29 cases, 15.1% ）, hypertension （72 cases, 37.5% ）. （2）M1 was 60.0%, E1 was 55.2%, S1 was 46.9%, T0, T1, T2 were 59. 9%, 22.9%, and 17. 2%, respectively, small artery thickening was 46.9%, patients with cellular ＋ fiberocellular crescents was 48.5%. Some pathology features were related to age. （3）Proteinuria was associated with the mesangial hypercellularity score, endocapillary hypercellularity, segmental sclerosis or adhesions, and tubular atrophy or interstitial fibrosis and cellular ＋ fiberocellular crescents. Blood pressure and renal function were associated with segmental sclerosis or adhesions, tubular atrophy or interstitial fibrosis, small artery thickening and cellular ＋ fiberocellular crescents. Conclusions The Oxford classification has a good clinical guide of treatment and prognosis of IgA nephropathy.
出处
《中国医师杂志》
CAS
2013年第1期42-45,共4页
Journal of Chinese Physician
