单纯性肾小球性血尿90例临床和病理分析

目的分析成人单纯性肾小球性血尿临床和病理特点，探讨血尿类型与病理严重程度的关系，寻找能较好反映单纯血尿患者肾脏病变程度的指标。方法选取90例单纯性肾小球性血尿患者为研究对象，分析不同病理类型的临床和病理特点；比较不同血尿类型以及不同肾小管间质损害程度患者的临床和病理学指标。结果90例患者中IgA肾病32例、局灶增生性肾小球肾炎27例，为最主要的病理类型。镜下血尿组各指标中除球性硬化、血管玻璃样变及IgA沉积外，其余各临床与病理指标均与肉眼血尿组无明显统计学差异。随着单纯血尿患者肾小管间质损害程度的加重，各病理参数积分均显著增加。结论成人单纯性血尿最主要的原因是IgA肾病，病理类型以局灶增生性肾小球肾炎最多见。不能单纯以血尿类型来判断肾脏病理严重程度。肾小管间质损害可以反映单纯性血尿患者的病变程度。

A retrospective analysis on clinical and pathological characteristics of 90 cases of isolated glomerular hematuria

Objective To study the clinical and pathological features of isolated hematufia in adults, explore the relationship between different types of hematuria and the pathological severity, and find out the ideal indicators mirroring the pathological severity in patients with isolated hematuria. Method Clinical and pathologic findings from 90 adult patients with isolated glomerular hernaturia in our department were reviewed. The clinical features and pathological types of these patients were analyzed retrospectively. These patients were divided into two groups： isolated persistent microscopic hematuria, and paroxysmal gross he- moturia, and their clinical and pathological data were compared. Result Among the 90 cases of isolated hematuria, IgA nephropathy was the most comrron pathological type （32 cases）, followed by focal proliferative glomerulonephritis （27 cases）. According to Katafuchi semiquantitative scoring system, except the sores of the glomemlosclerosis, vascular hyalinization and the deposition of IgA, there was no significant difference （P〈0. 05） between the two groups in the clinical and pathological data. With the severity of tubulointerstitial lesions, the scores of the pathological data were increased significantly. Conclusion IgA nephropathy and focal proliferative glomemlonephritis were the most common pathological types of isolated hematuria- The pathological severity cant be evaluated hy the clinical types of hematuria- Tulouloinerstitial lesions may be one of the key indicators for the prognosis of isolated hematuria