IgA肾病小管间质损害与预后相关分析

目的观察IgA肾病患者肾小管间质损害与临床表现及肾组织病理改变之间的关系。方法选取经临床病理诊断明确的IgA肾病患者143例，根据小管间质损害的程度进行临床和病理指标的比较。结果①143例IgA肾病患者中，83．92％出现小管间质损害，其中轻度占65．03％，中度占16．08％，重度占2．80％。②随着小管间质损害程度的加重，女性患者所占比例逐渐增大，年龄和血压呈逐渐升高的趋势，血浆白蛋白水平呈下降趋势，而24h尿蛋白定量、血肌酐、总胆固醇水平呈明显升高趋势。③随着小管间质损害的加重，患者肾小球损害和血管损害也随之加重（P〈0．05）。结论小管间质损害是决定IgA肾病预后的关键因素之一，但不是唯一因素，应将临床参数与病理参数，间质损害指标与肾小球、肾血管损害指标相结合，综合评价患者预后。

The relationship between tubulointerstitial lesion and clinical,pathological indexes in IgA nephropathy

Objective To observe the relationship between tubulointerstitial lesion （TIL） and clinical manifestation, pathological changes in IgA nephropathy. Methods 143 patients with IgAN were enrolled in our study. According to the severity of TIL, those patients were divided into 3 groups： without TIL,mild TIL, moderate to severe TIL. The clinical and pathological parameters were compared among the groups. Results （1）In 143 patients with IgA nephropathy,83.92% had TIL,in which 65.03 % was mild, 16.08 % moderate,and 2. 8 % severe, respectively. （2）With the aggravation of TIL, the ratio of female patients was increased;the age and blood pressure had a trend of gradual increase, serum albumin was gradually decreased,and the quantity of 24 h urinary protein,serum ereatitine and serum cholesterol were obviously increased. （3）With the aggravation of TIL, the injures of glomeruli and renal interstitial vessels were aggravated simultaneously. Conclusion TIL is one of the key factors to determine the prognosis of IgA nephropathy. It should combine clinical and pathological indexes, or tubulointerstitial,glomerular and vascular parameters to evaluate the prognosis of lgA nephropathy.