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目的 探讨IgA肾病 (IgAN)进展为慢性肾功能不全 (CRI)的病理学危险因素。方法 对 6 40例经肾活检确诊的IgAN病人进行平均 5 3个月的追踪观察。用病例对照法研究所有病人的病理学资料 ,同时还对其中 2 0 4例活检当时肾功能正常 ,5年后发展为CRI或终末期肾功能衰竭(ESRF) (n =18)以及 5年后肾功能仍保持正常 (n =186 )的病例进行了比较。结果 弥漫性系膜增生型 (DMP)为最常见的病理型 ,占 5 0 %。 / 间质纤维化 ,>40 %硬化肾小球 , / 血管病变 ,局灶节段透明变性及硬化 (FSHS)的均为预测肾功能恶化的危险因素 ,其中FSHS的意义更大 (P <0 0 0 0 1)。结论 FSHS的存在是IgAN病人正常肾功能进展恶化的显著指标。
Objective To investigate the pathological risk factors of IgA nephropathy (IgAN) progression to chronic renal insufficiency (CRI). Methods Six hundred and forty patients with IgAN confirmed by renal biopsy were followed up for an average of 53 months. A case-control study of all patients with pathological data, but also of which 224 cases of renal function was normal at that time, 5 years after the development of CRI or end-stage renal failure (ESRF) (n = 18) and 5 years later The cases in which renal function remained normal (n = 186) were compared. Results Diffuse mesangial proliferative (DMP) was the most common pathological type, accounting for 50%. / Interstitial fibrosis,> 40% sclerosis glomeruli, / vascular lesions, focal segmental degeneration and sclerosis (FSHS) were all risk factors for predicting renal dysfunction, of which FSHS was more significant (P <0 0 0 0 1). Conclusions The presence of FSHS is a significant indicator of the worsening of normal renal function in IgAN patients.