Linné T, Aperia A, Broberger O, Bergstrand A, Bohman S O, Rekola S
Acta Paediatr Scand. 1982 Sep;71(5):735-43. doi: 10.1111/j.1651-2227.1982.tb09512.x.
The pathophysiology of IgA GN was investigated in different stages of the disease. Seventeen patients who were between 3.5 and 16.5 years of age at the onset were included in the study. Clearance studies were performed repeatedly in 6 patients (in 5 of them over a period extending from the onset to 5-9.5 years) and only once in 9 patients (10-23 years after the onset). Two patients (one with uremia) were only evaluated clinically. CIn, CPAH and UNaV were studied during hydropenia (HP) and 3% isotonic saline volume expansion (VE). Shortly after the onset CIn, CPAH and UNaV were depressed. Renal function was essentially normal and 1 and 2 years after the onset in spite of signs of active disease. A supernormal GFR was found in 7 patients after they had had the condition between 5 and 17 years. After a duration of IgA GN for greater than 9 years 3 of 12 patients had developed hypertension and uremia and 2 had hypertension or labile BP. Three of 10 patients had a normal GFR and BP, but had increased natriuresis during VE. Only 2 of 10 patients were normotensive and had normal renal function. Disturbances in the renal function are thus frequent in all stages of IgA GN and the changes seem to be related to the duration of the disease. Exaggerated natriuresis may indicate progressive disease.
在IgA肾病的不同阶段对其病理生理学进行了研究。研究纳入了17例发病时年龄在3.5至16.5岁之间的患者。对6例患者进行了多次清除率研究（其中5例从发病至5 - 9.5年期间进行了多次），9例患者仅进行了一次（发病后10 - 23年）。2例患者（1例患有尿毒症）仅进行了临床评估。在禁水（HP）和3%等渗盐水扩容（VE）期间研究了内生肌酐清除率（CIn）、对氨基马尿酸清除率（CPAH）和尿钠排泄分数（UNaV）。发病后不久，CIn、CPAH和UNaV降低。尽管有疾病活动迹象，但发病1年和2年后肾功能基本正常。7例病程在5至17年的患者出现了超常的肾小球滤过率（GFR）。IgA肾病病程超过9年后，12例患者中有3例出现高血压和尿毒症，2例出现高血压或血压不稳定。10例患者中有3例GFR和血压正常，但在扩容期间尿钠排泄增加。10例患者中只有2例血压正常且肾功能正常。因此，在IgA肾病的所有阶段肾功能紊乱都很常见，且这些变化似乎与疾病持续时间有关。尿钠排泄增加可能表明疾病进展。
