IgM肾病9例临床病理分析

　　【摘要】 目的 探讨IgM肾病(IgMN)实验室检查指标与肾活检组织病理变化的关系，寻找控制IgMN进展的关键因素。方法 经光镜、免疫荧光和电镜诊断为IgMN的9例肾活检病例，对肾小球、肾小管、肾间质及血管壁的各项病理参数进行组织学观察，同时复习相关文献。结果 IgMN患者同时检出血尿和蛋白尿者达44.4%;以单纯IgM和IgM+C1q沉积，IgM+C3+C1q沉积，IgM+IgG+C1q沉积为主;肾功能异常(BUN,Cr)在肾小管、肾间质及血管壁增厚方面与肾功能正常者差异有显著性(P<0.05);肾功能异常与肾小球硬化差异有显著性(P<0.05)，与系膜细胞和系膜基质增生及肾小球的节段性病变差异无显著性(P>0.05)。结论 未出现肾功能不全的IgMN患者，积极抗感染，控制蛋白尿及肾小球、肾小管、肾间质和血管壁的病变进展，是阻止IgMN发展为终末肾的关键。

　　【关键词】 IgM肾病;预后

　　IgM nephropathy:clinical and histopathological studies of 9 cases

　　WU Yan,SU Li,LI Xiu-xia,et al.

　　Inner Mongolia Medical College,Hohhot 010059，China

　　【Abstract】 Objective To detect the relationship between laboratory parameters and pathological changes of renal biopsy,and to seek for key factors to control progress of IgM nephropathy(IgMN).Methods IgMN was diagnosed in 9 cases of renal biopsy with optical microscopy,immunofluorescence technique and electron microscopy.Every pathological parameter of glomerulus,renal tubules,renal interstitium and vascular wall were analyzed and related literature was reviewed.Results Hematuria and proteinuria were detected in 44.4% cases,in which the most common finding was simple IgM and IgM+C1q deposit,IgM+C3+C1q deposit,IgM+IgG+C1q deposit.There was a significant difference between cases with abnormal renal function(BUN,Cr) and those with normal renal function in the thickness of renal tubules,renal interstitium and vascular wall aspect(P<0.05).There was also an obvious difference between renal abnormity and glomerulus sclerosis(P<0.05),but the difference between renal abnormity and mesangial cell,mesangial matrix proliferation,and segmental pathologic change was not significant(P>0.05).Conclusion It is the key important for IgMN patients without renal insufficiency to carry actively on anti-inflammatory treatment,control proteinuria and progress of pathological lesion on glomerulus,renal tubules,renal interstitium and vascular wall in prevention of IgMN

[1] [2] [3] 下一页