摘要
目的:探讨IgA肾病(IgAN)伴有恶性高血压继发血栓性微血管病(thrombotic microangiopathy,TMA)患者的临床病理特点。方法:回顾分析经肾活检证实的5例IgAN伴发恶性高血压继发TMA患者的临床病理资料,并与同期收治的6例原发性恶性高血压继发TMA的患者进行比较。结果:临床表现方面:两组均表现为恶性高血压,不同程度的血尿、蛋白尿及肾功能损害,IgAN组尿蛋白定量、血尿程度明显高于非IgAN组,差异有统计学意义(P<0.05)。病理活检方面:IgAN组肾血管病变程度及肾小球病变程度重于非IgAN组。结论:IgAN伴发恶性高血压性TMA肾损害与原发性恶性高血压性TMA肾损害临床与病理表现有所不同。当临床鉴别诊断困难时,肾组织病理检查是鉴别两类疾病的有效手段。
Objective： To evaluate the characteristic of clinical and pathological of IgA nephropathy with thrombotic microangiopathy （TMA） secondary to malignant hypertension patients. Methods： From Feb. 2004 to Dec. 2011, a case control retrospective study was carded out in 5 cases of IgAN with TMA which secondary to malignant hypertension and 6 cases of TMA secondary to malignant hypertension as control.Results： Clinical manifestation of two groups showed that both groups had malignant hypertension, hematuria, proteinuria and renal injury. The IgAN group had significantly higher proteinuria and hematuria （P〈0.05, vs un-IgAN group）; kidney pathology of 11 cases showed that the IgA group possessed severer glomerular pathological changes and the degree of pathological changes of glomerular artery was inferior than un-IgAN group. Conclusion： IgA nephropathy with TMA secondary to malignant hypertension is different from that without IgAN in clinical and pathological manifestation. When it is difficult to diagnosis, renal biopsy is an important method to identify these two diseases.
出处
《温州医学院学报》
CAS
2013年第3期187-190,共4页
Journal of Wenzhou Medical College
关键词
高血压
恶性
治疗
肾小球肾炎
IGA
病理学
hypertension, malignant
therapy
glomerulonephritis
IgA
pathology
