Vas T, Kovács T, Kocsis B, Nagy J
Pćsi Orvostudományi Egyetem, II. Belgyógyászati Klinika, Nephrológiai Centrum.
Orv Hetil. 1998 Feb 15;139(7):349-52.
Tubulointerstitial changes seems to be of decisive importance among factors influencing the prognosis of IgA nephropathy. In consequence of decreased protection ability of mucous membranes, in some cases masked urinary tract infections may stand in the background of the tubulointerstitial changes. In this study the connection between urinary tract infections, significant bacteriurias and the progression of IgA nephropathy was retrospectively investigated. The data and the progress of the disease of 19 IgA nephropathy patients with significant bacteriuria (microbiologically identified) were compared to 19 IgA nephropathy patients of similar age, sex and the time of follow-up without bacteriuria. During the follow-up (on the average 8.5 years), the renal function (values of serum creatinine) decreased significantly (p < 0.05) in both groups, but there was no significant difference between the two groups. Neither at start, nor at the end of the follow-up no significant difference was found in the two groups in the prevalence of proteinuria, haematuria, hypertension and between the values of serum parameters. On the basis of these data we assume, that with the help of frequent medical check up and adequate antibiotic treatment the unfavourable effects of urinary tract infections (chronic tubulointerstitial changes) can probably be fended off.
在影响IgA肾病预后的诸多因素中，肾小管间质改变似乎起着决定性作用。由于黏膜保护能力下降，在某些情况下，隐匿性尿路感染可能是肾小管间质改变的潜在原因。本研究对尿路感染、显著菌尿与IgA肾病进展之间的关系进行了回顾性调查。将19例有显著菌尿（经微生物学鉴定）的IgA肾病患者的数据及疾病进展情况，与19例年龄、性别及随访时间相似但无菌尿的IgA肾病患者进行比较。在随访期间（平均8.5年），两组的肾功能（血清肌酐值）均显著下降（p<0.05），但两组之间无显著差异。在随访开始时和结束时，两组在蛋白尿、血尿、高血压的发生率及血清参数值方面均未发现显著差异。基于这些数据我们推测，通过频繁体检和适当的抗生素治疗，或许可以抵御尿路感染（慢性肾小管间质改变）的不利影响。
