【摘要】：目的探討成人原發(fā)性IgA腎病(IgAN)患者腎臟IgM沉積與臨床及病理的關(guān)系。方法收集經(jīng)皮腎活檢病理證實(shí)為成人原發(fā)性IgAN的147例患者,分為IgM陰性組和IgM沉積組,對兩組的臨床表現(xiàn)、實(shí)驗(yàn)室檢查及腎臟病理進(jìn)行比較分析。結(jié)果 1與IgM陰性組相比,IgM沉積組患者腎病綜合征的例數(shù)、24 h尿蛋白定量、24 h尿蛋白/肌酐、尿總蛋白及血尿素氮均明顯增加,血白蛋白及腎小球?yàn)V過率(e GFR)、血IgG明顯下降,慢性腎臟病(CKD)分期更重,尿轉(zhuǎn)鐵蛋白、尿白蛋白、尿IgG及尿N-乙酰β-D-氨基葡萄糖苷酶(NAG)明顯增加,差異有統(tǒng)計(jì)學(xué)意義(P0.05);2 IgM沉積組Lee氏分級Ⅳ級比例增加,但兩組間差異無統(tǒng)計(jì)學(xué)意義;牛津分類中兩組間比較,M、E、S差異無統(tǒng)計(jì)學(xué)意義,T分類中IgM沉積組病理損害更重,且差異有統(tǒng)計(jì)學(xué)意義(P0.05);用Katafuchi半定量分析,結(jié)果顯示IgM沉積組的腎臟病理總積分、腎小管間質(zhì)積分與IgM陰性組相比差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論腎臟IgM沉積的成人原發(fā)性IgAN患者的尿蛋白程度更高,臨床表現(xiàn)更重,腎小球損傷明顯,病理表現(xiàn)中腎小管間質(zhì)病變及腎臟總的病理損害更為明顯。
[Abstract]:Objective to investigate the relationship between renal IgM deposition and clinical and pathological changes in adult patients with primary IgA nephropathy (IgAN). Methods 147 cases of adult primary IgAN confirmed by percutaneous renal biopsy were divided into IgM negative group and IgM deposition group. The clinical manifestations, laboratory examination and renal pathology of the two groups were compared and analyzed. Results 1Compared with the negative IgM group, the cases of nephrotic syndrome in the IgM negative group were as follows: 24 h urinary protein / creatinine, urinary total protein and blood urea nitrogen were significantly increased, and the serum albumin and glomerular filtration rate (e GFR),) IgG were significantly decreased. The (CKD) stage of chronic kidney disease was more serious, urinary transferrin, urinary albumin, urinary IgG and urinary N- acetyl 尾 -D- glucosaminidase (NAG) were significantly increased (P0.05) Lee grade 鈪，

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