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目的探讨IgA肾病患者肾小动脉病变与临床、病理的相关性。方法 60例IgA肾病患者,根据肾小动脉病变程度分为未见明显病理改变组(A组,25例)、肾小动脉增厚组(B组,31例)和肾小动脉增厚伴透明样变组(C组,4例),分析三组肾小动脉病变程度与其临床指标及病理学参数的相关性。结果三组肾小动脉病变程度与血肌酐水平(P<0.01)、血尿酸(P<0.05)、收缩压(P<0.05)、舒张压(P<0.05)呈明显正相关。三组肾小动脉病变程度与内皮细胞增生指数(P<0.01)、系膜细胞增生指数(P<0.05)、肾小球慢性化指数(P<0.01)、间质炎症指数(P<0.01)、肾小管萎缩纤维化指数(P<0.05)呈明显正相关。结论肾小动脉病变在IgA肾病中病情评估中有重要作用,可作为预测肾脏预后的指标之一。
Objective To investigate the correlation between renal artery lesion and clinical and pathological features in patients with IgA nephropathy. Methods Sixty patients with IgA nephropathy were divided into two groups according to the degree of renal arterial lesion: group A (25 cases), thickening group (group B: 31 cases), thickening of renal arterioles (C group, 4 cases). The correlation between the severity of renal artery lesion and its clinical parameters and pathological parameters was analyzed. Results The severity of renal arterioles in the three groups was positively correlated with serum creatinine (P <0.01), serum uric acid (P <0.05), systolic pressure (P <0.05) and diastolic pressure (P <0.05). The degree of lesion of renal arterioles in three groups was significantly correlated with endothelial cell proliferation index (P <0.01), mesangial cell proliferation index (P <0.05), glomerular chronicity index (P <0.01) , Tubular atrophic fibrosis index (P <0.05) showed a significant positive correlation. Conclusion The renal arterioles lesion plays an important role in the assessment of IgA nephropathy and may be used as an index to predict the prognosis of kidney.