IgA肾病临床表现与肾脏超微结构关系的横断面研究
发布时间：2018-11-03 07:03
【摘要】：目的通过分析51例IgA肾病患者的临床表现与肾脏病理超微结构,探讨IgA肾病的临床表现及其肾脏病理超微结构的关系。方法收集从2014年2月到2015年12月期间在广西医科大学第一附属医院肾内科住院,资料完整,排除继发性肾脏病,经肾活检确诊为IgA肾病的51例患者。记录纳入患者的一般情况资料(性别、年龄、身高、体重、血压等)、实验室指标(24小时尿蛋白、免疫球蛋白三项、尿酸、eGFR CKD-EPI、补体C3、C4等)以及肾活检病理光镜结果及电镜结果。根据患者病史是否出现肉眼血尿、入院后24小时尿蛋白定量及肾活检电镜下系膜区电子致密物大小进行分组比较。比较各组间一般临床资料、实验室指标及肾脏病理超微结构。结果1、IgA肾病患者基底膜不均匀增厚,节段变薄。基底膜的厚薄在肉眼血尿及非肉眼血尿组差异有统计学意义,P0.05。2、足突融合的差异在蛋白尿分组有统计学意义,P0.05。3、电子致密物面积大小分组在身高、基底膜、纤维蛋白原及血清IgA方面的差异有统计学意义,P0.05。4、电子致密物面积10000000nm2的IgA肾病患者的肾脏病理分型主要为FSGS(87.5%)。电子致密物面积≤10000000nm2的患者的肾脏病理类型主要为FSGS(占34.09%)及轻系膜增生性肾小球肾炎(31.82%)。结论1、基底膜变薄是IgA肾病产生肉眼血尿的主要原因。2、足突融合程度与蛋白尿程度相关。3、电子致密物沉积面积与血尿、蛋白尿关系不大,与血清IgA、基底膜厚度及病理类型有关。
[Abstract]:Objective to investigate the relationship between the clinical manifestations of IgA nephropathy and the ultrastructure of renal pathology in 51 patients with IgA nephropathy. Methods 51 cases of IgA nephropathy diagnosed by renal biopsy were collected from February 2014 to December 2015 in Department of Nephrology, the first affiliated Hospital of Guangxi Medical University. General information (sex, age, height, weight, blood pressure, etc.), laboratory parameters (24 hours urine protein, immunoglobulin, uric acid, eGFR CKD-EPI, complement C3, etc.) were recorded. (C 4 et al.) and pathological and electron microscopic findings of renal biopsy. According to the patient's history of gross hematuria, 24 hours urine protein quantification and electron density size of Mesangial area under electron microscope of renal biopsy were compared. The clinical data, laboratory indexes and renal ultrastructure were compared. Results 1 the basement membrane was unevenly thickened and segmental thinning in patients with IgA nephropathy. There were significant differences in thickness of basement membrane between naked hematuria group and non-naked hematuria group (P0.05.2). The difference of foot process fusion was statistically significant in proteinuria group (P0.05.3). There were significant differences in basement membrane, fibrinogen and serum IgA (P0.05.4). The renal pathological classification of IgA nephropathy patients with electron dense area 10000000nm2 was FSGS (87.5%). The main renal pathological types of patients with electron density 鈮，
本文编号：2307052
[Abstract]:Objective to investigate the relationship between the clinical manifestations of IgA nephropathy and the ultrastructure of renal pathology in 51 patients with IgA nephropathy. Methods 51 cases of IgA nephropathy diagnosed by renal biopsy were collected from February 2014 to December 2015 in Department of Nephrology, the first affiliated Hospital of Guangxi Medical University. General information (sex, age, height, weight, blood pressure, etc.), laboratory parameters (24 hours urine protein, immunoglobulin, uric acid, eGFR CKD-EPI, complement C3, etc.) were recorded. (C 4 et al.) and pathological and electron microscopic findings of renal biopsy. According to the patient's history of gross hematuria, 24 hours urine protein quantification and electron density size of Mesangial area under electron microscope of renal biopsy were compared. The clinical data, laboratory indexes and renal ultrastructure were compared. Results 1 the basement membrane was unevenly thickened and segmental thinning in patients with IgA nephropathy. There were significant differences in thickness of basement membrane between naked hematuria group and non-naked hematuria group (P0.05.2). The difference of foot process fusion was statistically significant in proteinuria group (P0.05.3). There were significant differences in basement membrane, fibrinogen and serum IgA (P0.05.4). The renal pathological classification of IgA nephropathy patients with electron dense area 10000000nm2 was FSGS (87.5%). The main renal pathological types of patients with electron density 鈮，
本文编号：2307052
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