IgA肾病随增龄变化的特点及其与预后指标的关系

目的　研究不同年龄组 Ig A肾病临床预后指标、病理改变的特点及其相关性。方法　回顾性分析 90 7例 Ig A肾病患者的临床与肾活检病理资料。结果　 Ig A肾病主要临床预后指标 ,如蛋白尿水平、高血压及肾功能状态随增龄有逐渐加重的趋势 ,随增龄 Ig A肾病患者的病理分级加重。全球硬化、间质纤维化、间质炎细胞浸润、肾小管萎缩、血管病变等各项积分随年龄增加升高 ,系膜增殖、节段硬化、球囊粘连及新月体积分在各年龄组之间无统计学差异。结论　 Ig A肾病在不同年龄组的临床表现、病理改变特点不同 ,随年龄增加 ,主要临床预后指标、病理分级及病理预后指标积分均有加重趋势 ,因此年龄可能是影响预后的一个重要指标。这提示对于不同年龄段的 Ig A肾病患者应该采取不同的治疗措施

Study on the association of prognostic indices with the renal pathological lesions with aging in IgA nephropathy

Objective To explore the characteristics of clinical prognostic indices and renal pathological lesions of IgA nephropathy patients in different age-stage, as well as the association between them.Methods The clinical and renal biopsy pathological data of 907 cases with IgA nephropathy were analyzed retrospectively.Results The main clinical prognostic indices of IgA nephropathy including the situation of renal function, the level of proteinuria and hypertension were aggravated with aging. The pathological grades and the scores of lesions of global glomerulosclerosis, interstitial fibrosis, interstitial inflammatory infiltration, tubular atrophy and vascular injury were all increased with ageing.Conclusions In IgA nephropathy, the characteristics of clinical manifestation and renal pathological lesions were different apparently among different age-stage groups. There were tendencies of aggravation in both clinical and pathological indices with aging. So age may be an important factor that may affect the prognosis of IgA nephropathy, which indicated the treatment of different age-stage IgA nephropathy should be different.