50例IgA肾病临床及病理分析

目的探讨IgA肾病（IgAN）患者临床与病理类型间的关系及大量蛋白尿对肾功能的影响。方法50例经皮肾穿刺活检确诊为IgA肾病的病人，根据24h尿蛋白定量是否大于3g分为大量蛋白尿组与非大量蛋白尿两组，进行临床特点、病理等资料的回顾性分析。结果IgA肾病以血尿并发蛋白尿最多见，占92％，伴发高血压占48％，伴发急性肾功能不全26％，慢性肾功能不全各占30％．病理分级高，提示肾损害严重，预后不良。大量蛋白尿组的血肌酐显著高于非大量蛋白尿组。结论大量蛋白尿可能是促进IgA肾病的肾功能损害进展的独立因素。

Pathological and Clinical Analysis of IgA Renopathy of 50 Cases

Objective To discuss the relationship between clinical manifestation and pathology in IgA nephropathoy,and the influence to renal function with mass proteinuria. Methods Clinical data of 50 patient,swith primary IgA nephropa thy diagnosed by biopsy were collected. Their clinical features,pathology and immuno - pathology were ret retrospectively analyzed. Results Hematuria and proteinuria were commonest in IgA nephropa thy （92% ） . 48% of patients Complicated with hypertension ,26% with acute renal failure and 30% with chronic renal failure. Through pathologic grade was no correlated with clinical type or immuno pathology,but severe pathologic lesions predict poor prognosis. The level of serum creatinine in group with mass proteinuria was higher than that in group with mild or moderate proteinuria. Hypertension was factors ofpoor prognosis. Conclusion Mass proteinuria may aggravate the damage selfly in renal function in IgA nephropathy.