IgA肾病蛋白尿与肾小管间质病理改变的关系

目的探讨蛋白尿与IgA肾病（IgAN）肾小管间质病理损伤的关系。方法经病理确诊为IgAN患者33例。以尿蛋白2．0g／d为界分为显著性蛋白尿组13例（39．40％），及非显著性蛋白尿组20例（60．60％）。肾小管间质病理损害情况分为无病变、轻度、中度及重度损害4种情况。比较两组病例各项临床指标的改变以及肾小管间质病理损伤程度与尿蛋白定量的关系。结果两组间临床指标比较除尿蛋白定量差异有显著性外。余项差异均无显著性（P〉0．05）。肾小管间质病理损害程度与24h尿蛋白定量呈正相关（P〈0．05）。结论IgAN蛋白尿可能是肾小管间质损害的重要因素之一，故对有显著蛋白尿的IgAN患者应给予积极有效的治疗。

Relationship between poteinuria and tubulointerstitial lesions in patients with IgA nephropathy

Objective] To investigate the relationship between proteinuria and tubulointerstitial lesions in patients with IgA nephropathy (IgAN). Methods] According to the boundary line of 2.0 g/24 h, 33 IgAN patients diagnosed by renal biopsy were divided into an intense proteinuria group (group A) (n =13) and a no-intense proteinuria group (group B) (n =20). Prevalence characteristics of tubuloin terstitial lesions: no-TIL, mild TIL, moderate TIL and severe TIL, the clinical findings of the two groups patients with IgA nephropathy were comp- aned the relationship between TIL and Upro/24 h was found. Results] Except for Upro/24 h among all clinical findings, there was not significant difference between the two groups patients with IgAN (P >0.05) and when the Upro/24 h was higher, the severity of TIL also increased (P <0.05). Conclusion] Upro/24 h may be one of the key factors in the patients with IgAN, therefore, the IgAN patients with intense proteinuria should be treated positively and effectively.