血清IgA、C3及IgA／C3与IgA肾病诊断及病理分级的关系

目的比较IgA肾病与非IgA肾病患者血清IgA、C3和IgA／C3水平差异以及观察IgA肾病患者血清IgA、C3及IgA／C3水平与病理Lee氏分级的相关性，探讨血清IgA、C3及IgA／C3水平与IgA肾病的诊断及病理分级的关系，方法中山大学附属第二医院肾内科及中山大学附属第三医院经肾活检穿刺病理检查确诊为原发性IgA肾病126例与非IgA肾病原发性肾小球肾炎患者123例，用散射比浊法检浸4两组患者的血清IgA、C3水平及按Lee氏分级标准评估IgA肾病病理分级。结果①原发性IgA肾病患者与非IgA肾病原发性肾小球肾炎患者血清IgA水平分别为[（2．91±1．75）vs（2．26±0．93）g／L，P〈0．01]；血清C3[（0．99±0．28）vs（0．99±0．20）g／L，P〉0．05]；②原发性IgA肾病患者与非IgA肾病原发性肾小球肾炎患者血清IgA/C3水平分别为[（3．08±1．60）vs（2．34±0．98），P〈0．01]；③Lee氏分级为Ⅰ和Ⅱ级与Lee氏分级为Ⅲ、Ⅳ、Ⅴ级的IgA肾病患者血清IgA水平分别为[（2．70±1．70）vs（3．06±2．06）g/L，P〉0．05]；血清C3水平分别为[（1．07±0．30）vs（0．95±0．25）g/L，P〈0．05]；血清IgA／C3水平分别为[（2．69±1．25）vs（3．32±1．76），P〈0．05]。结论血清IgA水平及IgA／C3值可作为鉴别IgA肾病与非IgA肾病的参考指标，C3水平的降低程度与IgA肾病患者病理严重程度密切相关，本研究结果为今后临床借助非创伤性的方法协助诊断IgA肾病与评估IgA肾病患者的肾脏病变程度提供了一种依据。

The Relationship between the Serum IgA,C_3,IgA/C_3 Levels and IgA Nephropathy

Objective Compare the difference of serum IgA,C3,IgA/C3 levels between the patients with IgA nephropathy(IgAN) and other with non-IgAN and observe the correlation between the serum IgA,C3,IgA/C3 levels and Lee's grading system.Furthermore,to explore the relationship between the serum IgA,C3 levels,IgA/C3 ratio and the diagnosis or pathologicalgrading of IgAN.Methods 126 patients with primary IgAN and 123 patients with other primary glomerulonephritis were diagnosised by renal biopsy in the third affiliated ...