目的对比分析IgA肾病中、老年(年龄>40岁)患者与青少年(年龄<40岁)患者病理改变特点。方法将我院189例经肾活检确诊为原发性IgA肾病患者分为中、老年和青少年两组,分别回顾性分析其病例组织光镜和免疫荧光检查的相关资料。结果在189例病理资料中,青少年组以轻度改变为主,免疫荧光检查以单纯IgA或C3沉积多见;而中老年组病例改变相对较重,中-重度改变者较多见,免疫荧光检查以单纯IgA或C3、IgA+IgM沉积较多。结论疑诊为IgA肾病的患者,尤其是老年人,应及时肾穿以利于早期诊断。 Objective To compare and analyze the pathological changes of patients with IgA nephropathy, elderly (aged> 40 years) and adolescents (aged <40 years). Methods 189 cases of primary IgA nephropathy diagnosed by renal biopsy in our hospital were divided into two groups: middle and old age group and adolescent group. The related data of histopathological examination and immunofluorescence were retrospectively analyzed. Results In 189 cases of pathological data, mild changes were mainly found in adolescent group, and IgA or C3 deposition was more common in immunofluorescence. In middle-aged and elderly patients, the changes were relatively heavier, moderate to severe changes were more common, and immunofluorescence Check with simple IgA or C3, IgA + IgM deposition more. Conclusion Suspected IgA nephropathy patients, especially the elderly, should be timely kidney to facilitate early diagnosis.