IgA肾病520例临床病理分析

目的研究IgA肾病(IgAN)的临床和病理特点及其相互关系。方法对1992年11月～2003年6月温州医学院附属第一医院肾内科病理室肾活检诊断的原发性IgAN520例进行临床与病理分型关系的分析。结果520例IgAN临床表现以无症状性尿检异常最常见,占346例(66.5%),其次是慢性肾炎和肾病综合征,分别占77例(14.8%)和66例(12.7%)。病理类型以局灶节段硬化性肾小球肾炎最常见,占186例(35.8%),其次是系膜增生性肾小球肾炎、轻微病变肾小球肾炎和局灶节段增生性肾小球肾炎,分别为116例(22.3%)、104例(20%)和63例(12.1%)。结论IgAN的临床病理表现多样化并具有一定特点。临床表现最常见为无症状性尿检异常,在病理上最常见的是局灶性肾小球病变类型。

Clinicopathological study of 520 cases with IgA nephropathy diagnosed by renal biopsy

Objective To investigate the relationship between clinical features and pathomor phological types in IgA nephropathy(IgAN). Methods A positive diagnosis of primary IgAN was made after successive native renal biopsies in 520 patients in The First Affiliated Hospital of Wenzhou Medical College between November 1992 and June 2003.The clinical features and pathomorphological types of these patients were analyzed retrospectively. Results Asymptomatic hematuria with or without the presence of proteinuria was the most common clinical manifestation(66 5%), followed by chronic nephritis(14 8%) and nephrotic syndrome(12 7%) .Pathologically, focal segmental glomerulosclerosis(FSGS) was the most frequent type(35 8%), followed by mesangial proliferative glomerulonephritis(MsPGN,22 3%) and minimal lesion (ML,20%) among the 520 patients with IgAN. Conclusions The relation between the clinical manifestation and pathomorphological type of IgAN is complicated. Asymptomatic hematuria with or without the presence of proteinuria is the most common clinical manifestation and focal segmental glomerular lesion is the most common pathomorphological type of IgAN.