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伴和不伴新月体形成的IgA肾病的临床与病理研究
引用本文:沈世忠,郭冰云,吴建平,杨忠民,蔡佳盈,胡义阳,王晓松.伴和不伴新月体形成的IgA肾病的临床与病理研究[J].中国中西医结合肾病杂志,2008,9(9):795-797.
作者姓名:沈世忠  郭冰云  吴建平  杨忠民  蔡佳盈  胡义阳  王晓松
作者单位:1. 福建医科大学附属泉州市第一医院肾内科,泉州,362000
2. 福建省泉州市医学高等专科学校,泉州,362000
摘    要:目的:探讨伴和不伴新月体形成的原发性IgA肾病(IgAN)临床和病理特点。方法:分析128例经肾活检确诊IgAN患者,分析其临床特点,并根据新月体形成所累及肾小球的比例分组:无新月体形成为A组,69例;≤10%为B组,25例;〉10%〈50%为C组,34例。根据Katafushi积分分析肾脏病理。结果:(1)临床方面:B组和C组的血尿素氮(BUN)较A组高(P〈0.05);C组血肌酐(Scr)较A组高(P〈0.01);B组和C组的收缩压(SBP)较A组高(P〈0.01);C组舒张压(DBP)较A组高(P〈0.01)。(2)病理方面:C组肾小球总积分比A组、B组高(P〈0.01),B组肾小球总积分比A组高(P〈0.01);B组球性硬化积分比A组高(P〈0.01),C组球性硬化积分比A组高(P〈0.01);C组节段损害、肾小管间质、炎症细胞浸润积分比A组高(P〈0.01)。结论:原发性IgAN随着新月体形成所累及肾小球的比例增加,血压有逐渐升高趋势;肾脏病理损害逐渐加重,故对有新月体形成原发性IgAN应早期干预治疗,以延缓肾病进展。

关 键 词:肾小球肾炎  IgA肾病  病理学  新月体  血压

Clinical and pathological study of IgA nephropathy with or without crescents
Institution:SHEN Shizhong , GUO Bingyun , WU Jianping , et al (Division of Nephrology, the First Affiliated Hospital of Quanzhou, Fujian Medical University, Quanzhou 362000)
Abstract:Objective: To study the Clinical and pathological features of lgA nephropathy (lgAN) with or without crescents. Methods:Clinical and pathological characteristics of 128 patients with IgAN were reviewed. These patients were divided into three groups according to the percentage of glomeruli affected by crescents or without crescent. Results.Blood urea nitrogen (BUN)of patients in Group B was higher than that in Group A and patients in Group C was higher than that in Group A(P〈0.05). Serum creatinine(scr) of patients in Group C was higher than that in Group A( P 〈 0.01 ). Systolic bood pressure(SBP) of patients in Group B was higher than that in Group A and that of patients in Group C was higher than that in Group A(P〈0.01 );Diastolic blood pressure(DBP) of patients in Group C was higher than that in Group A(P 〈 0.01 ). Glomerular total score of patients in Group B was higher than that in Group A( P 〈 0.01 ) ; Glomemlar total score in Group C was higher than that in Group A and that in Group B(P〈0.01 ). Score of glomerular globe sclerosis in Group B was higher than that in Group A and that in Group C was higher than that in Group A( P〈 0.01 ). Score of Segmental lesion, renal tubule and interstitial and inflammatory cell infiltration in Group C were higher than those in Group A( P 〈 0.01 ). Conclusion.With increase percentage of glomeruli affectet by crescents, blood pressure of patients tends to be gradually elevated, which results in gradual renal damage.
Keywords:C-lomerulonephritis lgA nephropathy Pathology Crescent Blood pressure
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