IgM肾病的研究现状.pdfVIP

中华临床医师杂志( 电子版)2015 年4 月第9 卷第8 期 Chin J Clinicians(Electronic Edition),April 15,2015,Vol.9,No.8 ·1429 · ·综述· IgM 肾病的研究现状 熊建琼 杜晓刚 【摘要】 IgM 肾病指肾组织免疫荧光检查发现系膜区有弥漫性IgM沉积（IgM是唯一或最主要 的沉积成分），光镜下可见肾小球系膜细胞增殖或肾小球结构基本正常的原发性免疫复合物介导的肾 小球疾病。临床上可发生于任何年龄，儿童多见，多数以肾病综合征起病，少数表现为蛋白尿、单 纯血尿或蛋白尿合并血尿，血清IgM升高。目前研究提示，IgM 肾病预后不容乐观。基于其病因和发 病机制不清，其病理特点也不尽相同，临床表现也多种多样。该文将主要介绍IgM 肾病的病因和发 病机制、组织和病理特点、临床表现、诊断、治疗及预后等情况。 【关键词】 肾病综合征； 肾病，脂性； 肾功能衰竭，慢性； IgM 肾病 The current research status of IgM nephropathy Xiong Jianqiong, Du Xiaogang. Department of Nephrology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China Corresponding author: Du Xiaogang, Email: dxgcxm@163.com 【Abstract 】 IgM nephropathy refers that kidney immunofluorescence examination found IgM diffusely deposites mesangial area (IgM is the only or the main composition), and light microscopy can find glomerular mesangial cell proliferation or basic normal glomerular structure of primary glomerular disease mediated by primary immune complexes. IgM nephropathy can happen at any age, mostly in children, most with nephrotic syndrome, a few of proteinuria, simple hematuria or proteinuria with hematuria, and elevated serum IgM. Current studies suggest that the IgM nephropathy prognosis is not optimistic. Based on its etiology and pathogenesis is not clear, its pathological characteristics are also different, clinical manifestations are also varied greatly. The etiology and pathogenesis, the pathological characteristics, the clinical manifestations, diagnosis, treatment and prognosis, and etc. of IgM nephropathy were mainly introduced in this article. 【Key words 】 Nephrotic syndrome ; Nephrosis, lipoid; Renal disease,