IgA肾病86例临床和病理分析

目的 :了解IgA肾病患者的临床表现及其病理情况。方法 :对 1984年 6月～ 2 0 0 0年 12月间经肾活检证实为IgA肾病患者 86例随访资料进行分析。结果 :以感染为首次发病诱因者 4 2例 ,其中呼吸道感染 36例。存在血尿 79例 ,蛋白尿 83例 ;伴高血压 4 0例 ;发生急性肾衰竭 4例。治疗前内生肌酐清除率 (Ccr>70ml/min 6 2例 ,5 0～ 70ml/min 15例 ,2 5～ 5 0ml/min 8例 ,<2 5ml/min 1例 ;治疗后Ccr>70ml/min 73例 ,5 0～ 70ml/min 5例 ,2 5～ 5 0ml/min 4例 ,<2 5ml/min 4例。除肾小球系膜增生外 ,病理改变以间质炎症和肾小球硬化出现的比例最高 ,其次为肾小管萎缩、间质纤维化等。结论 :IgA肾病的临床表现以蛋白尿和血尿多见 ,且两者合并存在的机会多见 ;部分患者可出现血压升高及肾功能恶化。IgA肾病患者应早期进行肾活检检查

Analysis of Clinic and Pathology in 86 Cases with IgA Nephropathy

Objective: To study the clinical and pathological feature of IgA nephtopathy. Methods: The data of 86 patients with IgA nephropathy were analyzed. Results: Forty two cases were induced by infections. There were 79 cases with hematuria, 83 cases with proteinuria, 40 cases with hypertension, and 4 cases with acute renal failure. Before therapy, there were 62 patients with endogenous creatinine clearance(Ccr) more than 70ml/min, 15 patients with Ccr 50 to 70ml/min , 8 patients with Ccr 25 to 50ml/min,and 1 patient less than 25ml/min; after therapy, there were 73 patients whose Ccr were more than 70ml/min, 5 patients 50 to 70mi/min, 4 patients 25 to 50milmin, and 4 patients less than 25mi/min. In addition to glomerular mesangial proliferation, interstitial inflammation and glomerulosclerosis occurred with the highest rate. Renal tubule atrophy and interstitial fibrosis also presented. Conclusion:Hematuria and proteinuria are the most clinical feature of IgA nephropathy, and they often present in combinaton. Some patients may get hypertension and renal dysfunction. Renal biopsy should be performed in early stage.