表现为肾病综合征的IgM肾病及非IgA系膜增殖性肾炎的临床病理差异

分析临床表现为原发性肾病综合征的微小病变肾病（ＭＣＤ）、ＩｇＭ肾病（ＩｇＭＮ）和非ＩｇＡ、ＩｇＭ系膜增殖性肾炎（ＭｓＰＧＮ）病理改变（微机定量图像分析）和临床表现的联系。发现：（１）３种疾病以ＩｇＭＮ发生率最高（４８．８９％），一过性肾功损害、激素依赖比例以ＭｓＰＧＮ为高，ＩｇＭＮ、ＭｓＰＧＮ存在明显血尿；（２）病理定量分析表明：ＩｇＭＮ和ＭｓＰＧＮ的系膜细胞数、系膜基质增宽及间质改变较ＭＣＤ明显增高（Ｐ＜０．０１），ＭｓＰＧＮ系膜区增宽比ＩｇＭＮ更明显（Ｐ＜０．０１）；（３）ＩｇＭＮ、ＭｓＰＧＮ间质病变越重，越易伴有高血压、血尿、一过性肾功损害和激素依赖，其中以ＭｓＰＧＮ更明显。表明ＩｇＭＮ肾病预后相对较好，而ＭｓＰＧＮ相对较差。

The differences of clinical features and renal morphology between patients with IgM nephropathy and mesangial proliferative glomerulonephritis in nephrotic syndrome

The renal pathological sections (by computer imaging quantitative analysis) and clinical manifestations in patients with minimal change disease (MCD), IgM nephropathy (IgMN) and non IgA, IgM mesangial proliferative glomerulonephritis(MsPGN) were analysed. The results showed that IgMN and MsPGN with nephrotic syndrome were 11.39% in primary glomerulonephritis. The prevalence of IgMN(48.89%) was the highest in thee kinds of renal disease. There were higher proportions of temporary renal dysfunction and dependance of corticoids in patients with MsPGN, but distinct hematuria occurred in patients with IgMN and MsPGN. The results of imaging quantitative analysis in renal pathological sections showed that the count of mesangial cells and area of mesangial matrix and renal interstititium in patients with IgMN and MsPGN were increased significantly than in patients with MCD( P <0.01) and the area of mesangial matrix in patients with IgMN( P <0.01);The more inceased area of renal interstitium was, the more hypertension, hematuria, temporary renal dysunction and dependance of corticoids were. It indicates that IgMN is a benign renal disease with specific clinical feature and renal morphologic change, but MsPGN is a relatively serious disease.