摘要
目的:了解IgA肾病伴恶性高血压(MHT)患者的临床病理特点和预后。方法:分析12例IgA肾病伴MHT(IgA组)的临床病理资料,并与同期收治的14例原发性MHT(原发组)进行比较。结果:与原发组相比,IgA组高血压家族史、高血压病史的比例、就诊年龄、血甘油三酯(TG)、血IgG、补体C3明显低于原发组;而收缩压(SBP)、舒张压(DBP)、尿蛋白定量、血尿、血IgA明显高于原发组。22例MHT肾脏病理:IgA组(12例),光镜下肾小球病变重,肾小球系膜增生及系膜基质增宽明显,而肾小动脉病变的程度低于原发组。原发组(10例),肾小动脉内膜重度增生,呈现典型的洋葱皮样改变或呈纤维素样坏死,肾小球毛细血管袢缺血皱缩和包蔓氏囊扩张。经治疗IgA组有效率25%,原发组有效率64.3%。结论:IgA肾病伴MHT的临床病理特点与原发性MHT不同,预后较原发性MHT差。
Objective：To uhderstand the clinical pathological characteristic and prognosis of IgA nephropathy with malignant hypertension patients. Method ：The clinical and pathological data of 12 cases IgA nephropathy with MHT were analyzed and compared with 14 cases primary MHT hospitalized at the same term. Results：Compared with primary MHT, proportion of positive hypertension family history and hypertension history,therapy age,blood TG, blood IgG and alexin C3 were decreased significantly. But SBP,DBP,urinary protein excretion,hematuria,and blood IgA were increased obviously. Kidney pathology of 22 cases showed that：The IgA group （12 cases） possessed heavy glomerular pathological changes, glomerular mesangial proliferation and obvious widening mesangial basic texture under optic microscope. The degree of glomerular artery pathological changes was inferior than that of primary MHT group. The primary MHT group （10 cases） possessed heavy glomerular artery inner velum hyperplasias that presented typical changes like onionskin or fibrinoid necrosis, glomerular capillary vessel crimple with scarce blood and Bowman＇s capsule dilatation. The effective rate of IgA group was 25% and that of primary MHT group was 64.3% after therapy. Conclusion： The clinical and pathological characteristics of IgA nephropathy with MHT is different from those of primary MHT and its prognosis is worse than that of the primary MHT.
出处
《中国误诊学杂志》
CAS
2005年第12期2215-2217,共3页
Chinese Journal of Misdiagnostics
