儿童原发性IgA肾病的临床与病理研究-儿科学专业论文.docxVIP

目 录 中文摘要········································································································1 英文摘要········································································································4 英文缩写········································································································8 研究论文 儿童原发性 IgA 肾病的临床与病理研究 前言········································································································9 研究对象及方法··················································································11 结果······································································································14 附图······································································································17 附表······································································································18 讨论······································································································24 结论······································································································29 参考文献······························································································30 综述 儿童原发性 IgA 肾病的诊疗进展····················································33 致谢··············································································································53 个人简历······································································································54 儿童原发性 IgA 肾病临床与病理研究 摘 要 研究背景: IgA 肾病（IgA nephropathy, IgAN）, 是于 1968 年由法国 学者 Berger 首先提出和命名的一种肾小球疾病, 是指肾小球系膜区有 IgA 或以 IgA 沉积为主的免疫球蛋白弥漫性沉积, 呈团块状或分散的颗粒状 分布, 可伴有 C3、C1q 的沉积, 也可伴有 IgM、IgG 的沉积[1]。作为儿童 时期最常见的原发性肾小球疾病, IgAN 是一种慢性进展性的疾病, 临床 上主要表现为感染后的反复发作性肉眼血尿或镜下血尿, 可伴有不同程 度的蛋白尿、高血压和肾功能损伤。虽然自发现至今已近 50 年, 但人们 对 IgAN 的认识仍然不够全面, 研究早期人们将其视为一种预后较好的良 性疾病, 但 Hogan 研究发现, IgAN 患者中经过 10 年及 20 年后有发展为 终末期肾功能衰竭（end-stage renal failure, ESRF）的慢性过程, 比率分别 为 15％~20％及 30％~40％[2], 由此可见, IgAN 已成为严重危害儿童健康 的重要疾病, 是引起 ESRF 的重要原因之