| Objective：Analyse the clinical features, pathological features and their correlation of IgANpatients, and find prognostic factors to provide the basis for evaluating the severity of illness,slowing disease progression and guiding the treatment.Materials and Methods：Review retrospectively330cases with IgAN diagnosed by renal biopsy in our hospitalwith clinical stage within CKD3,grouped according to the clinical manifestations, Lee’sgrading system,Fofi C semi-quantitative points,observe the clinical and laboratory markersof each group.The data comparison among multi-groups used analysis of variance, countdata used chi-square test. P value<0.05was a statistically significant difference, and Pvalue<0.01was considered that the difference was statistically significant.Result：1.Among330cases of IgAN patients, the ratio of female/male was1.2:1, genderdifferences in all ages had no significant difference(P>0.05);In two age groups21to30years and31to40years,there is maximum number of IgAN cases.2. Among330cases of patients with IgAN, the number of Lee’s class on Ⅲ was mostand the number of Lee’s class on Ⅰ andⅤ was less.3. The systolic blood pressure and diastolic blood pressure of patients with Lee’s classⅤ were higher than the patients with Lee’s class Ⅰ、Ⅱ、Ⅲ、Ⅳ,which was statisticallysignificant(P<0.05).4. Among330cases of IgAN patients,70.9%(234cases) showed hematuria withproteinuria,8.2%(27cases) showed hematuria without proteinuria,20.9%(69cases)showed proteinuria without hematuria, and hematuria with proteinuria were the mostcommon in various pathological grading. 5. GFR calculated by Chinese simplified MDRD formula, CKD-EPI equation and theCockcroft-Gault formula showed no significant difference (P>0.05).6. IgAN Lee’s high histological grade showed high levels of creatinine, low levels ofglomerular filtration rate (P<0.05), while blood urea nitrogen and serum albumin showed nosignificant difference (P>0.05).7. Compared with the simple gross hematuria group, serum creatinine and eGFR ofsimple microscopic hematuria group had no significant difference (P>0.05); Compared withmicroscopic hematuria with proteinuria group, eGFR of gross hematuria with proteinuriagroup was lower, glomerular index points and crescent index were higher,and the differencewas statistically significant (P<0.05).8. Crescent index of gross hematuria group was higher than microscopic hematuriagroup, and the difference was statistically significant (P<0.05).9. IgAN patients were grouped according to the score of various pathological indicatorsby using Fofi C integration method for the semi-quantitative. Comparison of serum IgAlevels between the groups had no statistically significant difference (P>0.05); With theincrease of integration the ratio of serum IgA/C3increased, and the difference wasstatistically significant (P<0.05).Conclusion：1. IgAN patients were more common in young people with no gender differences. Theclinical manifestations of hematuria with proteinuria was most prevalent.2. IgAN patients accepted renal biopsy were mainly at Lee’s pathological grade level Ⅲ;With the increase of pathological grade level, the values of blood pressure and serumcreatinine increased, and glomerular filtration rate decreased.3. GFR calculated by Chinese simplified MDRD formula, CKD-EPI equation and theCockcroft-Gault formula showed no significant difference.4. Hematuria severity of IgAN patients which showed hematuria without proteinuriawas not associated with renal function. The more serious degree of hematuria in the patientsof hematuria with proteinuria had more severe degree of renal impairment and renalpathological damage. 5. The more severe formation of crescents in patients with IgAN had heavier degree ofhematuria.6. The extent of renal pathological damage of patients with IgAN was independent ofserum IgA levels, but the more severe renal pathological damage has higher ratio of serumIgA/C3. |
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