临床医学论文-IgA肾病与过敏性紫癜性肾炎的临床和病理对比分析

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1、ffU!临床医学论文・IgA肾病与过敏性紫瘢性肾炎的临床和病理对比分析作者：周长华蔡林祥朱月文居建析徐宏【摘要】目的对比研究有新川体形成（<50%）的IgAN肾病（IgAN）和过敏性紫瘢性肾炎（HSPN）在临床及肾脏病理改变上的异同，探讨两者的关系。方法对经肾活检证实的病理上有<50%新月体形成的25例IgAN及23例HSPN成人（>18岁）进行临床及病理对比分析。结果IgAN和HSPN临床表现和似，高血压、血尿、蛋门尿、尿NAG酶升高等发生率差异均无显着性（P>0・05）；IgAN肾功能损害程度

2、较重，两者的血肌酊水平差异有显着性（P<0・05）；IgAN和HSPN脏的组织病理检查，节段新月体形成率和球囊粘连、内皮增生、节段硬化等发生率差异均无显着性（P>0.05）,而祥坏死、球性皱化、肾间质纤维化、肾小管萎缩发生率差异均有显着性（PvO.05）；两组免疫病理均以IgA在系膜区沉积为主（伴或不伴血管祥的沉积），沉积差异无显着性（P>0.05）。结论IgAN与HSPN两者在高血压、血尿、蛋口尿发生率等临床表现差异无显着性，但IgAN肾功能减退明显，肾组织发生球性硕化、间质纤维化、小管萎缩等慢

3、性化病变较重。【关键词】IgA肾病过敏性紫瘢性肾炎新月体临床和病理【Abstract]ObjectiveTocomparetheclinicalandpathologicalcharactersisticsinpatientswithcrescentic（<50%）IgAnephropathy（IgAN）andHenoch-Schonleinpurpuranephritis（HSPN）.Thepresentstudyaimedtocharacterizetheirrelationshipthrou

4、ghclinicopathologicalcomparisonbetweenIgANandHSPN.Methods25adultwithIgANand23adultwithHSPNinthisstudy.Theirclinicalmanifestations,bloodbiochemicaltest,renalpathologicalfindingsinlightmicroscopyandimmunofluorescencewereanalyzedandalsocomparedbetween25I

5、gANand23HSPN・ResultTheclinicalpatternsofIgANandHSPNweresimilar.Hypertension/hematuria(severeandmirror)/proteinuriaandurineNAGenzymaticarisingwerenotsignificant(P>0・05)・ButinIgAN,renalfunctionwasdamagedbadlyandtheserumcreatininewassignificantlyhigherth

6、anthatinHSPN(P<0・05)・Pathologicalexamination,suchassegmentalcrescents/glomcruli・Bowman'scapsuleadhesion/endothelialproliferationandsegmentsclerosiswerefoundsimilarlyinIgANandHSPNpatients(P>0.05).Whiletheglobalsclerosis/renalinterstitialfibrosisandtubu

7、laratrophyweremarkedlyhigherinIgANthanthatinHSPNpatients(P<0.05).Capi1larynecrosiswas1owerinIgANthaninHSPNpaticnts(P<0.05)・Al1thecasesinbothgroupshadIgAdepositioninglomerulus・Nosignificantdifferencewasfoundthedepositionsof,IgG,IgM・C3,C4andClqonglomeru

8、lusbetweentwogroups(P>0・05)・ConclusionsTheclinicalpatternsofIgAnephropathyandHSPNweresimilar.Whilethepathologicalchangessuchasrenaldysfunction,globalsclerosis,renalinterstitiumfibrosisandtubularatrophyweremarkedlyseriousinIgANthanthoseinHSPNpa