Funai M, Okada K
Nihon Jinzo Gakkai Shi. 1989 Sep;31(9):933-40.
A comparative clinico-pathological study was performed on 61 children and 51 adults with IgA nephropathy. Hematuria and/or proteinuria found by chance was the most common initial clinical sign, being observed in 82.0% of the children and 52.9% of the adults (p less than 0.001). At renal biopsy, hypertension and severe proteinuria were found in 9.8% and 33.3% of the adults and 0 and 14.8% of the children (p less than 0.05, p less than 0.05). Elevations of blood urea nitrogen and serum creatinine were found at the time of biopsy in 21.6% and 9.8% of the adults but in none of the children (p less than 0.001, p less than 0.05). On histological studies, proliferative changes of the glomerulus were similar in the two groups, and diffuse mesangial proliferation was found in 62.3% of the children and 51.0% of the adults (although the difference was not significant). Focal glomerulosclerosis and tubular atrophy were found in 52.9% of the adults and 32.8% of the children (p less than 0.05). These results suggest that focal glomerulosclerosis with tubular atrophy is correlated with deterioration of renal function, hypertension and age at renal biopsy, and has an important influence on the prognosis of patients with IgA nephropathy.
对61例儿童和51例成人IgA肾病患者进行了一项临床病理对照研究。偶然发现的血尿和/或蛋白尿是最常见的初始临床症状,在82.0%的儿童和52.9%的成人中观察到(p<0.001)。肾活检时,9.8%的成人和0%的儿童发现高血压,33.3%的成人和14.8%的儿童发现严重蛋白尿(p<0.05,p<0.05)。活检时,21.6%的成人和9.8%的成人发现血尿素氮和血清肌酐升高,但儿童均未发现(p<0.001,p<0.05)。组织学研究显示,两组肾小球的增殖性改变相似,62.3%的儿童和51.0%的成人发现弥漫性系膜增殖(尽管差异不显著)。52.9%的成人和32.8%的儿童发现局灶性肾小球硬化和肾小管萎缩(p<0.05)。这些结果表明,伴有肾小管萎缩的局灶性肾小球硬化与肾功能恶化、高血压及肾活检时的年龄相关,对IgA肾病患者的预后有重要影响。