Clinical-pathological Analysis On 206 Patients With IgA Nephropathy

Background: IgA nephropathy is the group of clinical disease with renal glomerulus immune pathology characteristic. It is the most common kind of primary renal glomerulus disease in the whole world. IgAN incidence of disease in our country is relatively high too. IgAN is followed the trail for more than 20 years, about 20-50% of the patients develop to end stage renal failure. Still there is no effective treatment method up until now. Its clinic and kidney pathology display the polytropy and multiplicity. IgAN clinical manifestation and prognosis are extremely uneven.It is very difficult to judge simply the extent of damage of kidney and prognosis through the clinical index. And kidney pathology grade have important value to assess prognosis. Objective: The study of the relationship among IgAN patient's clinical characteristic, pathology grade and prognosis is to find early the reason of prognosis mala, judge the condition synthetically, direct the clinical treament, and delay the progress of the pathogenetic condition. Methods: Reviewing retrospectively is done about the clinic and laboratory index of 206 patients with IgAN, whose final diagnosis is through renal puncture biopsy from 1997.6 to 2005.2 in our hospital, including age, sex, course of disease, blood pressure, serum creatinine, serum fibronectin, 24-hour urine protein amount.In light microscope detection, kidney organize is calssified from I to IV grade consults Lee grade system. Renal tubule interstitial leision is classified from Ito V grade.Immunoflurescence is divided into four category on the basis of IgA deposit, regarding to combine IgG and(or) IgM deposit .Observe the incidence of high blood pressure of each group, serum creatinine, serum fibronectin , 24-hour urine protein amount. Analyse the epidemiology characteristic of IgAN, the relationship among each pathology indexes, clinical indexes and pathology grade relations. Count materials adopt X2 examine, mutiple interclass materials data comparision is based on mean square analysis and LSD-t to examine. Correlation is judge with Spearman's grade correlated analyzing. If P<0.05, it is significant on statistics . Results: IgAN accounts for 33.2% of the kidney biopsy in the same term of our hospital.which is the first place. The young male incidence of disease is high.The incidence of chlidren, middle-aged and old rise is low.Kidney pathology Lee classification takes II and III grade as the core in grades.While I and IV grade are small in proportion. I-III grade in TIL is common, while TIL IV is few. Lee of IgAN grades presents positive correlation with TIL. The IgAN kidney pathological change degree is serious when patients combines with high blood pressure.Higher the pathology grade is, higher the serum creatinine level is, heavilier damaged the kidney function is. The relaition between the extent of damage of kidney pathology and urine protein is not found. There isn't obvious difference of fibronectin index in different kidney pathology with variant Lee gardes. FN levels is high in patients with heavy TIL. The proportion of simple IgA and IgA +IgG deposit are high in immune pathology.But it isn't found that fluorescence deposit and pathology extent ofdamage have correlation. Discussion: This result shows that the incidence of IgAN is relatively high. It is the most common kind of primary renal glomerulus disease. The age range of IgAN is expanding with the extensive development of the kidney biopsy.But it is still take man between twenty and fifty as the core.The light and heavy degree of damage is rare in the kidney biopsy. The clinical manifestation of the lighter is hidden, patients fails to go to a doctor in time and doctor's attention degree is not enough; The heavy one has evolve in renal failure and biopsy is seldom done.Lee grade and TIL presents positive correlation in grades. It proves that TIL and renal glomerulus damage has positive correlation. This has certain directive significance to us when we get less renal glomerulus count or only medulla in kidney biopsy. It can be judged degree of the renal glomerulus of kidney according to TIL .Among the IgAN with high blood pressure, pathology classification grade is high and kidney damage is heavy. The appearance of the high blood pressure will accelerate the progress of IgAN. We should find early and control the progress of the blood pressure to delay IgAN progression effectively in time. IgAN patients with heavy pathology damagest is apt to damaged renal function. The positive and effective treatment should be adoptted to the patients whose kidney pathology grade is high in order to delay the progress. The relaition between the extent of damage of kidney pathology and urine protein is not found.The urine protein amout of each kind of grading is relatively high. Patients are short of complying considering the patients with simple hematuria or...