摘要
目的研究伴有肉眼血尿的IgA肾病患者临床及病理特点,指导临床治疗。方法经肾活检病理诊断为IgA肾病的患者76例,根据患者病程中是否出现肉眼血尿分为研究组和对照组,研究组22例,病程中均伴有肉眼血尿;对照组54例,不伴有肉眼血尿。应用Katafuchi半定量积分法分析患者肾脏病变程度,结合患者临床特点比较两组患者病理学改变及临床特点。结果①研究组患者前驱感染发生率显著高于对照组,高血压发生率低于对照组,血肌酐低于对照组,平均病程短于对照组(P<0.05)。两组患者24 h尿蛋白排泄量无统计学差异(P>0.05)。②研究组患者肾脏病理积分、血管积分、球硬化积分及血管壁增厚积分低于对照组(P<0.05)。结论伴有肉眼血尿的IgA肾病患者发病期多伴有前驱感染,病程中高血压发生率、血肌酐水平较不伴有肉眼血尿的IgA肾病患者低。病理改变较不伴有肉眼血尿的IgA肾病轻,预后相对较好。
Objective To study the clinical features of idiopathic IgA nephrepathy with gross hematuria. Methods Seventy six patients with IgA nephropathy diagnosed by renal biopsy were divided into study group and control group according to whether with gross hematuria or not. Twenty two patients with gross hematuria were allocated in study group; and 54 patients without gross hematuria were allocated in control group. Katafuchi semi - quantitative analysis had been applied for determination of the severity of renal lesions in patients, and it combined with clinical features had been applied to analyze the characteristics of pathological changes and clinical characteristics of patients. Results （!） Patients in study group were significantly higher in precursory infection rate, incidence of hypertension was lower than that of control group, serum level of creatinine was lower than that of control group, and mean duration of disease was shorter than that of control group （ P 〈 0.05 ）. The difference in amount of 24 h urinary protein excretion between patients of two groups was not significant （ P 〉 0.05 ）. （2） Scores of renal pathology, vascular scores, and scores of glomerular sclerosis and thickening of vessel wall were lower than those of control group （ P 〈 0.05 ）. Conclusion In patients with idiopathic IgA nephropathy associated with gross hematuria, the precursor stage usually accompanied with infection, the incidence of hypertension and serum level of creatinine compared with patients of IgA nephropathy without gross hematuria are usually lower, and their pathological changes are usually mild than those without gross hematuria, and their prognosis is relatively better.
出处
《临床和实验医学杂志》
2012年第15期1188-1189,共2页
Journal of Clinical and Experimental Medicine
关键词
IGA肾病
血尿
病理改变
临床特点
预后
IgA nephropathy
Hematuria
Pathological changes
Clinical features
Prognosis
