RESUMO
ABSTRACT:Objective To explore the relationship between clinical manifestations and pathological changes in patients with IgA nephrophathy.Methods To compare the clinical pathological data of 300 patients with primary IgA nephrophathy,who were diagnosised in the Shaanxi Chinese Hospital from Jan.2008 to Dec.2012.Results① The young and middle-aged had the highest incidence of IgA nephrophathy, about 9 0%, hematuria and proteinuria was the primary clinical manifestations among all ages,the incidence of hypertension and abnormal renal function was higher among 60-year age,about 29.3% and 28%.② The IgA+IgM deposition measured by immunofluorescence was the most common pathological type(3 6%).The ratio of IgA deposition was higher in LeeⅠ-Ⅲ of IgA nephrophathy,while IgA+IgM deposition was more common in Lee Ⅳ and Ⅴ (45.5% and 81.8%). The deposition of C3 was common in all IgA nephrophathy(6 3 .3%).③ Lee Ⅰ-Ⅳ grades were the more common grades,covered over 96.3%.Hematuria and proteinuria were the primary clinical manifestations inⅠ-Ⅴpathological changes grading.The incidence of hematuria,proteinuria,hematuria with proteinuria,and hypertension had no significant difference in all pathologic grading,but abnormal renal function had significant difference in Lee Ⅴ(P<0 .0 5 ).④ Abnormal of urine protein and RBC did not have significant difference in Lee Ⅰ-Ⅴ;C3 depositions in serum had significant difference in Ⅳ pathologic grading(P<0 .0 5 ).The elevation of IgA in serum had significant difference in Lee Ⅴ(P<0 .0 5 ).The proportion of abnormal serum creatinine(SCr)increased with the pathological grades,showing a rising trend.Conclusion IgA nephropathy has the characteristics of diversification of clinical manifestations and pathology changes. The incidences of hematuria, proteinuria and hypertension in IgA nephrophathy patients have no correlation with pathological grading;but with pathological grade promotion,the incidence of abnormal renal function increases.