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目的 :通过重复肾活检观察IgA肾病患者的病理改变。 方法 :将 12例IgA肾病患者行重复肾活检 ,观察2次肾活检时临床和实验室指标、肾组织病理积分以及系膜区IgA荧光强度的变化。 结果 :治疗后尿 2 4h蛋白定量明显减少 (P <0 .0 0 1) ,血IgA水平降低 (P <0 .0 5 ) ,但血肌酐、内生肌酐清除率、血压水平无统计学差异 (P >0 .0 5 ) ;2次肾活检比较 ,系膜增生程度明显减轻 (P <0 .0 0 1) ,节段硬化和球囊黏连明显减少 (P <0 .0 0 1) ,肾间质细胞浸润明显减少 (P <0 .0 1) ,新月体全部消失 ,间质纤维化程度减轻 (P <0 .0 0 1) ;球性硬化无统计学差异 (P >0 .0 5 ) ;系膜区IgA荧光强度明显减弱。结论 :IgA肾病进行早期治疗 ,不仅临床治愈 ,组织学也可逆转
Objective: To observe the pathological changes of patients with IgA nephropathy by repeated renal biopsy. Methods: Twelve patients with IgA nephropathy underwent repeated renal biopsy. The changes of clinical and laboratory indexes, pathological scores of renal tissue and IgA fluorescence intensity in mesangial area during two renal biopsy were observed. Results: After 24 h of treatment, urinary protein levels were significantly decreased (P <0.01), and blood IgA level was decreased (P <0.05), but serum creatinine, endogenous creatinine clearance and blood pressure were not significantly different (P> 0.05). Compared with the two renal biopsies, the mesangial proliferation was significantly reduced (P <0.01), and the segmental sclerosis and balloon adhesion were significantly decreased (P0.01) , The interstitial infiltration of renal interstitial cells decreased significantly (P <0.01), the crescent completely disappeared, the degree of interstitial fibrosis reduced (P <0.01), and there was no significant difference between the two groups .0 5); IgA fluorescence intensity of mesangial area was significantly weakened. Conclusion: IgA nephropathy for early treatment, not only clinical cure, histology can be reversed