Clinical Features And Pathological Analysis Of Patients With Primary IgA Nephropathy

Objective: The purpose of this retrospective study was to analyze the correlation between clinical features and pathological features in patients with primary IgA nephropathy;Methods: To collect the clinical manifestations,laboratory tests,pathological features,immunofluorescence data of patients with IgA nephropathy diagnosed by renal biopsy from 2011 to 2017 in the Department of Nephrology,Yijishan Hospital;Besides,it also excluded secondary IgA nephropathy from hepatitis b virus associated nephritis,lupus nephritis,purpura nephritis,According to age,the subjects were divided into four groups: 0--20 years old,21--40 years old,41-60 years old,61--80 years old;divided into two groups according to cystatin-c: Cystatin-c Normal group;cystatin-c abnormal group;divided into three groups according to Lee's grade: I-II grade;III grade;IV-V grade;retrospective analysis of clinical and pathological data consistent with standard primary IgA nephropathy;Results: The pathological types of groups were 21-40 years old age group accounted for the highest proportion.Hematuria group with the highest proportion of I-II level.Hematuria with albuminuria,albuminuria group with the highest level of III.Between the three groups,I-II level group P <0.05,the difference was statistically significant.CYS-C abnormal group of patients a total of 75 cases,with Lee grade increased,CYS-C size gradually increased,the three groups were compared P> 0.05,the difference was not statistically significant.There was significant difference between group III and group IV-V(P <0.05).A total of 173 cases of patients with abnormal urinary protein excretion in 24 h were detected.With the increase of Lee grade,the proteinuria of 24 h increased gradually,P <0.01,the difference was statistically significant.Compared with the cystatin-C normal group,creatinine,uric acid,low density lipoprotein and 24-hour urinary protein in patients with cystatin-C abnormalities were significantly increased,P <0.05,the difference was statistically significant.Albumin,total cholesterol,triglyceride decreased significantly,P> 0.05,the difference was not statistically significant.Among the 173 patients,39 cases were hypertension,accounting for 22.54%;49 cases were hyperuricemia,accounting for 28.32%;62 cases were hyperlipemia,accounting for 35.84%;Hypertension,hyperlipidemia and hyperuricemia group were the highest grade of Lee grade ?,accounting for 64.10%,59.18%,69.35% respectively.In all pathological grades,immunofluorescence showed a higher proportion of IgA pathological types(74.57%),followed by IgA + Ig M(23.12%),IgA + Ig G(1.73%)and IgA + Ig M + Ig G(0%).?-? type immunofluorescence simple IgA accounted for the highest proportion;? type immunofluorescence IgA + Ig M the highest proportion.In all IgAN,C3 showed the highest proportion of 85.55%.Conclusion: 1:The clinical manifestations of IGAN patients with hematuria and proteinuria most common..2:Grade III is the most common type of LEE in IGAN patients,and IgA is the most common immune complex deposition.Its clinical manifestations and the pathological grade there is a linear correlation.IgAN patients with proteinuria are more severe and pathological than those with isolated hematuria.3:hypertension,hyperuricemia,hyperlipidemia,proteinuria,renal insufficiency is a risk factor for IgA nephropathy in patients with pathological damage.Hypertension,hyperlipemia,hyperuricemia,and 24 h proteinuria were linearly correlated with pathological grade.4:Compared with the normal group of cystatin C,the patients in the abnormal group were older,with higher creatinine,uric acid,lipids and proteinuria.Serum levels of cystatin C in patients with IgA nephropathy correlate with renal pathology and reflect the severity of renal pathology;...