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目的 了解小儿 Ig A肾病 ( Ig A nephropathy,Ig AN)临床、病理及与预后的关系。方法 对肾活检病理诊断为 Ig AN的 3 0例病例进行临床与病理分析。结果 小儿 Ig AN临床表现以单纯肉眼血尿最常见 ,其与血尿伴蛋白尿者免疫复合物沉积均多为 Ig A+Ig G型 ,但前者临床及病理改变相对轻于后者。肾病综合征 ( NS)的临床及病理改变最重 ,易合并肾功能不全、高血压 ,以 Ig A+Ig G+Ig M型的免疫复合物沉积为主。结论 小儿 Ig AN预后与临床及病理分级有关 ,单纯肉眼血尿预后较好 ,NS、病理改变有肾小球硬化及免疫复合物沉积为 Ig A+Ig G+Ig M型者预后不良。
Objective To understand the clinical, pathological and prognostic significance of IgA nephropathy in children. Methods Thirty cases with pathologically diagnosed Ig AN in renal biopsy were analyzed clinically and pathologically. Results The clinical manifestations of IgAN in children were the most common manifestations of gross hematuria. The immunocomplexes with hematuria and proteinuria were mostly Ig A + Ig G type, but the clinical and pathological changes of the former were relatively lighter than the latter. Nephrotic syndrome (NS) has the most severe clinical and pathological changes and is easily associated with renal insufficiency and hypertension, with the deposition of immune complexes Ig A + Ig G + Ig M. Conclusions The prognosis of IgAN in children is related to the clinical and pathological grade. The prognosis of gross naked eye hematuria is good. The pathological changes of NS with glomerulosclerosis and immunocomplex are Ig A + Ig G + Ig M patients with poor prognosis.