D'Amico G, Minetti L, Ponticelli C, Fellin G, Ferrario F, Barbiano di Belgioioso G, Imbasciati E, Ragni A, Bertoli S, Fogazzi G
Q J Med. 1986 Apr;59(228):363-78.
Univariate survivorship analysis of a cohort of 365 patients with idiopathic IgA mesangial nephropathy and at least one year of further observation since the apparent onset (mean = 7.79 +/- 6.19 years; median = 6.16 years) has been performed. Observations for at least one year (mean = 5.05 +/- 3.66; median = 4.08 years) after biopsy was available for 292 of these. One immunohistological, four clinical, and six histological features were associated with increased risk of developing renal failure: (i) older at onset; (ii) no history of recurrent macroscopic haematuria; (iii) proteinuria of more than 1 g/day; (iv) arterial hypertension at the time of biopsy; (v) extent of glomerular obsolescence; (vi) extent of segmental glomerulosclerosis; (vii) presence of interstitial fibrosis; (vii) presence of diffuse intracapillary proliferation; (ix) presence of extracapillary proliferation; (x) presence of segmental thickening of glomerular basement membrane; (xi) extension of IgA deposits to the peripheral capillary loops shown by immunofluorescence. Only features (iii), (v), (vii) and (xi) proved to be independent prognostic indicators in the multivariate survivorship analysis (Cox regression model).
对一组365例特发性IgA系膜肾病患者进行了单因素生存分析，这些患者自明显发病后至少有一年的进一步观察期（平均=7.79±6.19年；中位数=6.16年）。其中292例患者在活检后至少有一年的观察期（平均=5.05±3.66；中位数=4.08年）。一种免疫组织学特征、四种临床特征和六种组织学特征与发生肾衰竭的风险增加相关：（i）发病时年龄较大；（ii）无反复肉眼血尿病史；（iii）蛋白尿超过1g/天；（iv）活检时动脉高血压；（v）肾小球荒废程度；（vi）节段性肾小球硬化程度；（vii）间质纤维化的存在；（vii）弥漫性毛细血管内增生的存在；（ix）毛细血管外增生的存在；（x）肾小球基底膜节段性增厚的存在；（xi）免疫荧光显示IgA沉积物延伸至外周毛细血管袢。在多因素生存分析（Cox回归模型）中，只有特征（iii）、（v）、（vii）和（xi）被证明是独立的预后指标。
