儿童IgA肾病临床与病理的关系

目的：探讨儿童IgA肾病(IgA nephropathy)临床特点、预后及其与病理的关系。方法：对肾活检病理诊断为IgA肾病52例儿童病例进行临床与病理分析。结果：本组儿童IgA肾病发生率占同期肾活检的13．6％，男性多于女性，临床表现以单纯血尿最常见，其次为蛋白尿伴血尿、肾病综合征，肾功能不全、高血压少见。蛋白尿伴或不伴血尿较单纯血尿光镜下病理改变严重，且免疫球蛋白的沉积以复合型为主，IgM沉积的比率高。结论：儿童IgA肾病临床特征与病理有一定的关系，单纯血尿者病理改变轻微，预后良好，蛋白尿者病理改变严重，应加强随访。

Discussiion on the correlation of the clinical characteristics with histopathologic features in childhood IgA nephropathy

Objective:To evaluate correlation of the clinical characteristics with pathologic features and prognosis in children IgA nephmpathy.Methods:The clinical cliaracteristics and histopathologic features of 52 cases with IgA nephropa-thy were analysed. Results: The incidence of IgA nephropathy is 13. 6% in ail the renal biopsies in our department of nephrology. The male-to-female ratio is 2.05:1. Asymptomatic hematuria is the most frequent presentation, Renal disfunction or hypertension are rare. The histopathologic expression showed that more severe lesion in patients with proteinuria with or witliout the presence, of hematuria than in ones with asymptomatic hematuria. Moreover,immunofluorescence microscopy demonstrated tliat the staining in the former ca.se is usually predominandy for the complex pattern of immunoglobulins containing IgM. Conclusion:There is a relative relationship between the clinical characteristics and pathologic features.