摘要
【目的】单中心研究原发性IgA肾病Legs病理分级特点及其临床相关性，为进一步探讨IgA肾病的发病机制提供依据。【方法】选取2003年10月至2006年9月在中南大学湘雅二医院肾内科住院经肾活检确诊的281例IgA肾病患者，分析其肾活检组织Lee＇s病理分级特点及其临床相关性。【结果】在281例IgA肾病患者临床资料分析结果发病男女比例为1：1．13；以21～30岁之间发病比例最多；以≥51岁患者平均病程最长，组间比较均有显著性差异（P〈0．05）。起病以感染为诱因者最多，占总例数的55．2％，其中呼吸道感染占53．4％（P〈0．01）。光镜下病理类型以系膜增生型（MsPGN）最多；Legs病理分级表现Ⅲ级最多（P〈0．01）。免疫荧光IgA沉积以系膜区为主。随着Lee＇s病理分级加重，其构成比逐渐减少；沉积在系膜＋毛细血管袢区，随着病理分级加重，其构成比逐渐增高（P〈0．05）。【结论】原发性IgAN是一组具有相同免疫病理特点的综合征，本文显示其不同的病理类型与临床以及与免疫复合物沉积之间的联系，为临床诊断和治疗提供了有力的依据。
[Objective] To investigate the features of Lee＇s pathological grade of primary IgA nephropathy and their clinical relation in order to provide the evidence for further studying the pathogenesis of IgA nephropathy. [Methods] Totally 281 patients with IgA nephropathy diagnosed by renal biopsy in the department of nephrology in second Xiangya hospital of Central South University from Oct. 2003 to Sept. 2006 were chosen. The features of Lee＇s pathological grade in renal biopsy tissue and their clinical relation were analyzed. [Results] The analysis of clinical data of 281 patients with IgA nephropathy showed that the ratio of male to female was 1 ：1.13 and the age of onset was mainly 21-31 years old, and the mean disease duration of patients aged 6ver 51 years old was the longest, and there were significant differences among all groups（ P〈0.05）. The major cause of the onset was infection（55.2% ） including respiratory tract infection（53.45）（ P〈0.01）. Under light microscope, the main pathological type was mesangial proliferation（MsPGN）, and the most of Lee＇s pathological grade was type Ⅲ （ P〈0.01）. Immunoinflurescence showed that IgA mostly deposited at mesangium and its constituent ratio decreased gradually with the increasing of Lees pathology grade, while IgA deposited at mesangium and capillary loop and its constituent ratio increased gradually with the increasing of Lee＇s pathology grade（ P〈0.05）. [Conclusion] Primary IgA nephropathy is the syndrome with the same immunological and pathological features. It indicates that different pathological types are associated with the clinic and immune complex deposit, which provides strong evidence for the clinical diagnosis and treatment.
出处
《医学临床研究》
CAS
2011年第6期1095-1098,共4页
Journal of Clinical Research
