原发性IgA肾病35例临床病理分析.docVIP

精品论文 参考文献 原发性IgA肾病35例临床病理分析 张斌 汪映龙 苍溪县人民医院 四川广元 628400 　　【摘要】 目的 探讨原发性IgA肾病患者临床表现与病理分级间的关系，为临床诊疗及判断预后提供依据。方法 回顾性总结分析 100 例经肾活检病理确诊为原发性IgA肾病的临床和病理资料。结果 例IgA肾病患者中男女比例为 ，发病平均年龄为 岁。病理分级越高，血尿素氮值越大，肾小球滤过率值随之降低，差异有统计学意义(P＜0.05)，年龄、收缩压、舒张压、24h尿蛋白定量在不同病理分级间无显著差异。临床表现以无症状尿检异常型最常见。临床表现及免疫病理类型与病理分级间均无显著差异。结论 IgA肾病好发于青壮年，临床表现多样化，病理分级越高，提示预后不良，早期行肾活检并行病理分级分析对IgA肾病指导治疗、判断预后有重要的临床意义。 　　关键词 IgA肾病；肾活检；病理分级；临床 　　Clinical features and Pathological Analysis of 113 Patients with Primary IgA Nephropathy 　　【Abstract】 Objective To discuss the relationship between clinical manifestation and classification of pathology with primary IgA nephropathy,for providing evidence for clinical treatment and prognosis. Methods The clinical and pathological data of 113 patients with primary IgA nephropathy diagnosed by renal biopsy were retrospectively analyzed.Results The male to female ratio is 1:1.13 and the average age of onset is 34.08plusmn;11.15 in 113 patients with IgA nephropathy.There are statistical significance of that the higher pathological classification,the biger values of blood urea nitrogen and the lower glomerular filtration rate(P＜0.05).There are no significant difference of age,systolic pressure,diastolic pressure and 24 hour urine protein excretion in the different pathological classification.Asymptomatic hematuria with or without the presence of proteinuria is the most common clinical manifestation。There are no significant difference between the clinical manifestation and pathological classification,both of the immuno pathology.Conclusion Youths and adults account for the most part of IgA nephropathy.The clinical manifestation is diverse,and severe pathologic lesions predict poor prognosis.Early renal biopsy and analysis of pathological classification has important clinical significance to guide the treatment and prognosis. 　　Keywords IgA nephropathy；Renal biopsy；Pathological classification；Clinic 　　IgA肾病是以肾小球系膜区大量IgA或以IgA为主的免疫球蛋白沉积为主要特点的临床最常见的原发性肾小球肾炎，在我国IgA肾病占肾活检诊断原