原发性IgA肾病50例临床与病理分析

目的：研究原发性IgAN的临床病理联系,并在轻重不同的病理组织间作以临床和实验室发现的比较分析。方法：将50例原发性IgAN患者根据病理组织分类方法将全部病例分为A、B两组。对两组病例进行临床表现、实验室检查有关数据及病理特征进行分析、总结。结果：本组病例中,临床分型以隐匿性肾小球疾病最常见。尿蛋白定性2、4 h尿蛋白、血β2-MG及IgA在肾组织中沉积的量与IgAN肾组织病理分级显著相关。结论：应对疑似IgAN的患者定期监测血、尿β2-MG及24 h尿蛋白定量,若有升高,应建议早期做肾穿刺活检,防止终末期肾脏疾病（end stage renal disease,ESRD）的发生。

Clinical Feature and Pathomorphological Types of 5O Cases with Primary IgA Nephropathy

Objective：To investigate the relationship between clinical feature and pathomorphological types in primary IgA nephropathy（IgAN）,and to compare and analyze the clinical records in the different level of pathological classification.Methods： A positive diagnosis of primary IgAN was made after successive native renal biopsies in 50 patients.These cases were divided into two groups by pathomorphological types： gradeⅠ-gradeⅢ was group A（25 cases）;gradeⅣ-gradeⅤwas group B（25 cases）.To analyze and summarize clinical manifestation,the data from the lab and pathology feature of the two groups cases.Results： Among these cases,latent glomerulonephritis was the most common clinical classification（64%）.There are positive correlations between serum β2-microglobulin,the level of proteinuria,the intensity of IgA immunofluovescence and pathological classification of IgAN.Conclusion： Monitoring of serum,urine β2-microglobulin and 24 hour urine protein is of very important significance in early undergoing renal biopsy,diagnosis,treatment and in prevention of end stage renal disease（ESRD）.