IgA肾病患儿临床病理的动态变化:附5例重复肾活检分析

目的 探讨IgA肾病患儿的临床表现和病理改变的动态变化。方法 分析5例重复肾活检的IgA肾病患儿的临床表现和病理改变的动态变化。结果 5例患儿中，4例进行2次肾活检，1例进行3次肾活检。5例患儿的基本临床表现均为持续镜下血尿伴间断肉眼血尿，并出现不同程度的蛋白尿及肾功能改变，其基本病理改变为不同程度的系膜增生。重复肾活检提示每例患儿的病理类型均有进展，且伴临床变化。结论 IgA肾病的临床表现及病理改变呈多样性、多变性，且病理类型可以转变。IgA肾病在出现病情反复或加重时，应进行重复肾活检以利于指导治疗，并提出IgA肾病时重复肾活检的指征。

Dynamic changes of clinical features and pathological lesions in children with IgA nephropathy: analysis of repeat renal biopsy in five cases

Objectives To explore the dynamic changes of clinical features and pathological lesions in children with IgA nephmpathy. Methods Clinical and pathological data of five children with IgA nephropathy were collected before and after each renal biopsy. Results Among 5 cases, 4 children were biopsied twice, 1 child had 3 times. Basic clinical manifestations of 5 cases were persistent microscopic hematuria or intermittent gross hematuria with varied levels of proteinuria and decreased renal function. The basic renal pathology was mesangial proliferation. Repeated renal biopsies showed pathological progression. Conclusions Clinical features and renal pathological changes of IgA nephmpathy were highly variable between cases. When severe relapse occurs, a repeat renal biopsy should be performed to provide information for further treatment. The indication for repeat renal biopsy was discussed.