摘要
目的比较目前国际上通用的IgA肾病分级方法Lee分级、Hass分级和WHO分级的一致性以及各种分级与临床指标的相关关系。方法对2006年2月至2008年9月中国医科大学附属第一医院278例原发性IgA肾病患者的病理标本分别进行3种病理分级,判断3种分级诊断IgA肾病严重程度时的一致性,综合探讨病理分级与临床指标的相关性。结果 Lee分级与Hass、WHO分级一致性差,Hass分级与WHO分级一致性较好。CKD分期、24 h尿蛋白定量、收缩压,舒张压,尿α1微球蛋白、微量白蛋白、转铁蛋白、IgG排泄水平与3种病理分级的严重程度均呈正相关;血白蛋白与病理分级的严重程度呈负相关。性别、病程、血IgA值、甘油三酯、高密度脂蛋白、血小板、纤维蛋白原、C3水平等与病理分级无关。结论 Lee分级与Hass、WHO分级在评价IgA肾病病理轻重时一致性差,Hass分级与WHO分级则一致性较好。当病理改变以活动性病变为主时,进行Lee分级更为恰当;而病理改变以硬化性病变为主时,进行WHO和Hass分级可更好地提示病情。
Objective To compare the current international IgA nephropathy grading methods （Lee classification,Hass classification and WHO classification） , and the correlation between various classifications and clinical indicators. Methods Classify 278 patients with primary IgA nephropathy according to three types of pathological classifications respectively in order to analysis the consistency and the correlation between various classifications and clinical indicators. Results There was poor consistency between Lee classification and Hass classification or WHO classification but there was favorable consistency between Hass classification and WHO classification. The severity of three types of pathological classification were positively related to CKD classification,24 hour urine protein excretion, systolic pressure ; diastolic pressure, urinary α1 MG, MA, TRF, IgG excretion level and negatively related to Albumin. There was no significant relationship between the three types of classification and gender, dura- tion of illness, blood IgA level, Triglyceride, high density lipoproteins, platelet, Fibrinogen, C3 level etc. Conclusion There was no consistency between Lee classification and Hass classification or WHO classification but there was favorable consistency between Hass classification and WHO classification. In evaluation of severity of disease, Lee classification is appropriate if active lesions were the most common pathological change ; WHO and Hass classification are appropriate if sclerotic lesions were the most common pathological change.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2010年第10期910-912,共3页
Chinese Journal of Practical Internal Medicine
关键词
IGA肾病
病理分级
尿蛋白
血压
IgA nephropathy
pathological classification
urine protein
blood pressure
