Hisano S, Kawano M, Kaku Y, Yamane I, Hatae K, Uragoh K, Matsuzaki A, Ueda K
Department of Paediatrics, Kyushu University, Japan.
Acta Paediatr Scand. 1991 Nov;80(11):1044-50. doi: 10.1111/j.1651-2227.1991.tb11781.x.
The clinical course of 43 children with IgA glomerulonephritis detected by mass urine screening was followed for a mean period of 8.1 years. Histological findings were graded according to the severity of glomerular and tubulointerstitial lesions. There was no correlation in the severity of histological grade and clinical outcome between subjects with microscopic hematuria and those with microscopic hematuria and proteinuria nor between those with and without one or more episodes of macroscopic hematuria during the follow-up period. None of the 35 children with proteinuria less than or equal to 1 g/m2/day had severe histological findings or developed renal impairment. In contrast, the 8 children with proteinuria greater than 1 g/m2/day had moderate and severe histological findings. Four of these 8 children developed hypertension or renal insufficiency during the follow-up period. Our study indicates that the outcome of screening detected IgA glomerulonephritis in children correlates with the level of proteinuria and the severity of renal pathology.
对43例通过大规模尿液筛查发现的IgA肾小球肾炎患儿的临床病程进行了平均8.1年的随访。根据肾小球和肾小管间质病变的严重程度对组织学结果进行分级。在随访期间，镜下血尿患儿与镜下血尿伴蛋白尿患儿之间，以及有或无一次或多次肉眼血尿发作的患儿之间，组织学分级的严重程度与临床结局均无相关性。35例蛋白尿≤1g/m²/天的患儿均无严重组织学表现或发生肾功能损害。相比之下，8例蛋白尿＞1g/m²/天的患儿有中度和重度组织学表现。这8例患儿中有4例在随访期间出现高血压或肾功能不全。我们的研究表明，筛查发现的儿童IgA肾小球肾炎的结局与蛋白尿水平及肾脏病理严重程度相关。
