192例IgA肾病小管间质损害的临床与病理研究

目的：探讨肾小管间质损害在IgA肾病的临床重要性。方法：分析192例IgA肾病的临床与病理资料。结果：IgA肾病伴有肾小管间质损害占85．4％，其中轻度损害占46．9％，中度损害占20．8％，重度损害占17．7％，无损害占14．6％。临床上血压升高、尿蛋白定量增多及肾功能减退是IgA肾病预后不良的临床因素。肾小球各项病理指标：血管损害、肾小球总体损害、系膜增殖程度及球性硬化的积分随着肾小管间质的损害程度增加，二呈平行关系。结论：肾小管间质损害在IgA肾病病理改变中广泛存在。随着其损害程度的加重，IgA肾病的病情逐渐加重，提示肾小管间质损害是决定IgA肾病预后不良的关键因素之一。

Clinical study of tubulointerstitial lesions in 192 patients with IgA nephropathy

Objective:To analyze the importance of tubulointerstitial lesions(TIL) in IgA Nephropathy(IgAN).Methods:The pathologic and clinical materials of 192 IgAN patients were analyzed.Results:The patients of TIL were about 85.4% in IgAN,mild TIL accounted for 46.9%, moderate TIL 20.8%, severe TILwas about 17.7% and these without TIL14.6%. Relationship between TIL and the pathologic findings: with increase of the severity of TIL, the scores of vascular lesion , total glomerular lesion, hypercellularity and glomeruloselerosis increased gradually.Conclusion:With the increase of the severity of TIL. the condition of IgAN patients became worse .TIL may be one of the key factors for the prognosis of IgAN.