蛋白尿在IgA肾病小管间质损害中的意义

目的探讨蛋白尿对IgA肾病（IgAN）小管间质病理变化的影响.方法对68例IgA肾病患者临床病理资料进行回顾性分析.根据24小时尿蛋白排泄量将68例患者分为A组（21例,＜1 g/24 h）、B组（33例,1.0～3.0 g/24 h）和C组（14例,＞3.0 g/24 h）.小管间质病理损害按Katafuchi R的半定量标准评分.结果蛋白尿程度增加,肾小管间质病理损害明显,组间比较有显著性差异（P＜0.05）.蛋白尿程度与尿视黄醇结合蛋白含量及血清C反应蛋白水平呈显著正相关（r=015302,P＜0102）.结论蛋白尿可能通过促进小管间质的免疫炎症反应,加重小管间质的损伤,是IgA肾病慢性进展的重要影响因子之一.对IgA肾病蛋白尿进行早期干预治疗有重要临床意义.

Proteinuria and pathologic features of patients with IgA nephropathy

Objective To investigate the relationship between proteinuria and pathological lesionof IgAN.Methods Proteinuria,pathology and clinical features in 68 cases with IgA nephropathy(IgAN)were retrospectively analyzed.According to the different levels of 24-hour urine protein quantity,68 pa-tients with IgAN who were diagnosed by renal biopsy were divided into group A(n=21),group B(n=33) and group C(n=14).Their tubulointerstitial lesions,retinol-binding protein and serum C-reactiveproteins were measured.Results There was positive correlation between the degree of proteinuria and thetubuloinsterstitial lesion.The levels of 24-hour urine protein in IgAN were correlated with retinol-bindingprotein and serum C-reactive protein.Conclusion The proteinuria could contribute to inflammation lesionin renal tubulointerstitial,it was one of determinant factors in chronic progressive IgAN and was very im-portant to intervene the proteinuria in IgAN early.