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目的探讨原发性IgA肾病患者临床表现与病理分级的关系,为临床诊疗及判断预后提供依据。方法对新疆医科大学第一附属医院肾病科经肾活检病理确诊为原发性IgA肾病的113例患者的年龄、血压、24h尿蛋白定量、肾小球滤过率、病理类型、临床表现及免疫复合物等进行回顾性分析。结果 113例IgA肾病患者中男女比例为1∶1.13,发病平均年龄为(34.08±11.15)岁,年龄在不同性别间差异有统计学意义(P<0.05)。病理分级越高,血尿素氮值越大,肾小球滤过率值随之降低,差异有统计学意义(P<0.05),收缩压、舒张压、24h尿蛋白定量在不同病理分级间、性别间差异无统计学意义。临床表现以无症状尿检异常型最常见,临床表现及免疫病理类型与病理分级间差异均无统计学意义。结论 IgA肾病好发于青壮年,临床表现多样化,病理分级越高,提示预后不良,早期行肾活检并行病理分级分析对IgA肾病指导治疗、判断预后有重要的临床意义。
Objective To investigate the relationship between clinical manifestations and pathological grade in patients with primary IgA nephropathy and provide evidence for clinical diagnosis and prognosis. Methods The age, blood pressure, 24h urinary protein, glomerular filtration rate, pathological type, clinical manifestations and immunity of 113 patients with primary IgA nephropathy confirmed by renal biopsy in Department of Nephrology, the First Affiliated Hospital of Xinjiang Medical University were analyzed. Complexes were retrospectively analyzed. Results The ratio of male to female in 113 cases of IgA nephropathy was 1: 1.13. The mean age of onset was (34.08 ± 11.15) years old. The age was significantly different between different sexes (P <0.05). The higher the pathological grade, the greater the blood urea nitrogen value, glomerular filtration rate decreased, the difference was statistically significant (P <0.05), systolic blood pressure, diastolic blood pressure, 24h urine protein in different pathological grades, Gender differences were not statistically significant. Clinical manifestations of asymptomatic urinalysis is the most common type of abnormal, clinical manifestations and immunopathological types and pathological grading differences were not statistically significant. Conclusion IgA nephropathy occurs in young adults. The clinical manifestations are diversified. The higher the pathological grade is, the worse the prognosis is. The early renal biopsy and pathological grading analysis have important clinical significance for guiding the treatment of IgA nephropathy and prognosis.