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本文报道经肾穿刺活组织免疫荧光染色证实的13例免疫球蛋白A(IgA)肾病病例。临床上,患者均以血尿起病,其中7例还伴有不同程度的蛋白尿,但无1例属于肾病综合征。13例中,内生肌酐清除率低于正常者5例,尿素氮轻度升高者1例,血压升高者3例,血清IgA升高者7例,抗“O”升高者3例。病理上,肾小球的病变主要表现为系膜细胞和系膜基质增生,免疫荧光染色证实小球内以系膜区IgA沉积为主,其中4例还伴有免疫球蛋白G(IgG)沉积。电镜下发现电子致密物以系膜区为突出,内皮细胞下或膜内也有稀疏的电子致密物沉积。最后就本病的临床、病理特征、肾小球内IgA。沉积和血清IgA水平的相互关系,治疗及预后等问题作了讨论。
This article reports 13 cases of immunoglobulin A (IgA) nephropathy confirmed by immunofluorescence staining of renal biopsy tissue. Clinically, patients with hematuria onset, of which 7 cases were associated with varying degrees of proteinuria, but none of nephrotic syndrome. Of the 13 cases, 5 cases had less than normal creatinine clearance rate, 1 case had mild increase in urea nitrogen, 3 cases had elevated blood pressure, 7 cases had elevated serum IgA, 3 cases had elevated anti-O . Pathologically, glomerular lesions mainly manifested as mesangial cells and mesangial matrix hyperplasia, immunofluorescence staining glomerular deposition of IgA in the mesangial area, of which 4 cases were associated with immunoglobulin G (IgG) deposition . Electron microscope found that the electron dense material is prominent in mesangial area, endothelial cells or membrane also have sparse electron density deposition. Finally, the clinical, pathological features of the disease, glomerular IgA. The relationship between deposition and serum IgA levels, treatment and prognosis were discussed.