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为探讨儿童IgA肾病病理特点与临床关系 ,对肾活检确诊为IgA肾病的32例病例进行临床分型、病理分级及免疫分型。结果发现临床表现为单纯性肉眼血尿15例 (46.9% ) ,肾病综合征10例 (31.3% ) ,肾炎综合征5例 (15.6 % ) ,单纯性蛋白尿2例 (6.2 % )。病理损害按Meadow分级共Ⅴ级 ,以第Ⅲ级为主 (50.0 % ) ,其次为第Ⅱ及第Ⅳ级 ,各占18.8 %和15.6 % ;单纯性肉眼血尿以第Ⅲ级为主 (53.3 % ) ;肾病综合征以Ⅲ及Ⅳ级为主 ,且肾炎性肾病的病理分级相对比单纯性肾病重。提示蛋白尿的程度与肾脏组织学改变密切相关 ;以肾病综合征为表现的IgA肾病病理改变均较重。
To investigate the pathological features of IgA nephropathy in children and its clinical relationship, clinical classification, pathological grading and immunophenotyping were performed on 32 cases diagnosed as IgA nephropathy by renal biopsy. The clinical manifestations were 15 cases (46.9%) of pure gross hematuria, 10 cases (31.3%) of nephrotic syndrome, 5 cases (15.6%) of nephritic syndrome and 2 cases of simple proteinuria (6.2%). According to Meadow, pathological lesions were classified as grade Ⅴ, grade Ⅲ (50.0%), followed by grade Ⅱ and Ⅳ (18.8% and 15.6% respectively), grade Ⅲ (53.3% ); Nephrotic syndrome is mainly in grade Ⅲ and Ⅳ, and the pathological grading of nephritic nephropathy is relatively heavier than that of simple nephrotic syndrome. Suggesting that the degree of proteinuria and renal histological changes are closely related to the performance of nephrotic syndrome IgA nephropathy are severe pathological changes.