【摘要】：目的通過分析51例IgA腎病患者的臨床表現(xiàn)與腎臟病理超微結(jié)構(gòu),探討IgA腎病的臨床表現(xiàn)及其腎臟病理超微結(jié)構(gòu)的關(guān)系。方法收集從2014年2月到2015年12月期間在廣西醫(yī)科大學第一附屬醫(yī)院腎內(nèi)科住院,資料完整,排除繼發(fā)性腎臟病,經(jīng)腎活檢確診為IgA腎病的51例患者。記錄納入患者的一般情況資料(性別、年齡、身高、體重、血壓等)、實驗室指標(24小時尿蛋白、免疫球蛋白三項、尿酸、eGFR CKD-EPI、補體C3、C4等)以及腎活檢病理光鏡結(jié)果及電鏡結(jié)果。根據(jù)患者病史是否出現(xiàn)肉眼血尿、入院后24小時尿蛋白定量及腎活檢電鏡下系膜區(qū)電子致密物大小進行分組比較。比較各組間一般臨床資料、實驗室指標及腎臟病理超微結(jié)構(gòu)。結(jié)果1、IgA腎病患者基底膜不均勻增厚,節(jié)段變薄。基底膜的厚薄在肉眼血尿及非肉眼血尿組差異有統(tǒng)計學意義,P0.05。2、足突融合的差異在蛋白尿分組有統(tǒng)計學意義,P0.05。3、電子致密物面積大小分組在身高、基底膜、纖維蛋白原及血清IgA方面的差異有統(tǒng)計學意義,P0.05。4、電子致密物面積10000000nm2的IgA腎病患者的腎臟病理分型主要為FSGS(87.5%)。電子致密物面積≤10000000nm2的患者的腎臟病理類型主要為FSGS(占34.09%)及輕系膜增生性腎小球腎炎(31.82%)。結(jié)論1、基底膜變薄是IgA腎病產(chǎn)生肉眼血尿的主要原因。2、足突融合程度與蛋白尿程度相關(guān)。3、電子致密物沉積面積與血尿、蛋白尿關(guān)系不大,與血清IgA、基底膜厚度及病理類型有關(guān)。
[Abstract]:Objective to investigate the relationship between the clinical manifestations of IgA nephropathy and the ultrastructure of renal pathology in 51 patients with IgA nephropathy. Methods 51 cases of IgA nephropathy diagnosed by renal biopsy were collected from February 2014 to December 2015 in Department of Nephrology, the first affiliated Hospital of Guangxi Medical University. General information (sex, age, height, weight, blood pressure, etc.), laboratory parameters (24 hours urine protein, immunoglobulin, uric acid, eGFR CKD-EPI, complement C3, etc.) were recorded. (C 4 et al.) and pathological and electron microscopic findings of renal biopsy. According to the patient's history of gross hematuria, 24 hours urine protein quantification and electron density size of Mesangial area under electron microscope of renal biopsy were compared. The clinical data, laboratory indexes and renal ultrastructure were compared. Results 1 the basement membrane was unevenly thickened and segmental thinning in patients with IgA nephropathy. There were significant differences in thickness of basement membrane between naked hematuria group and non-naked hematuria group (P0.05.2). The difference of foot process fusion was statistically significant in proteinuria group (P0.05.3). There were significant differences in basement membrane, fibrinogen and serum IgA (P0.05.4). The renal pathological classification of IgA nephropathy patients with electron dense area 10000000nm2 was FSGS (87.5%). The main renal pathological types of patients with electron density 鈮，

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