IgA肾病伴毛细血管袢坏死的临床病理分析

目的:分析IgA肾病伴毛细血管袢坏死(Necrotizing IgA nephropathy, NIgAN)患者的临床和病理特点.方法:对15例NIgAN患者,进行回顾性分析其临床及肾脏病理参数,并和不伴毛细血管袢坏死的IgA肾病(Non-NIgAN)患者进行比较.结果:两组患者在临床指标,如蛋白尿程度、高血压发生率、肾功能水平之间无统计学差异;在肾活检指标中,NIgAN组与Non-NIgAN组相比,仅在新月体形成比例有统计学差异(P<0.01).结论:IgA肾病伴毛细血管袢坏死在总体IgA肾病中并不少见,临床表现无特殊,故常规肾活检显得尤为重要.

The Clinicopathological Study of Idiopathic IgA Nephropathy with Segmental Necrotizing Lesions of the Capillary Wall

Objective:To analyze the clinical and pathological features of idiopathic IgA nephropathy with segmental necrotizing lesions of the capillary wall.Methods:Fifteen hospitalized IgAN patients with segmental necrotizing lesions of the capillary wall in our division were reviewed retrospectively.The clinicomorphologic features were compared with those of a control group of IgAN patients who lacked active segmental necrosis.Results:Patients with the necrotic variant showed more marked crescent formation ( P <0.01), No significant difference was found in clinical findings such as amount of proteinuria, level of blood urine nitrogen and frequency of hypertension.Conclusion:IgA nephropathy with segmental necrotizing lesions of the capillary wall,were found in about 5% of patients with idiopathic IgAN. Clinical findings were not different from those of the patients with IgAN. Therefore, renal biopsy should be more important in the patients.