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目的探讨原发性IgA肾病与低补体血症的关系。方法选择2006年1月～2009年6月经皮肾穿刺活检确诊为IgA肾病154例,并排除狼疮性肾炎、乙肝相关性肾炎等继发性因素。分析其补体C3浓度,其中低补体C3血症41例,占原发性IgA肾病发生率26.6%,将各种临床表现与低补体血症进行统计学分析。病理类型按WHO分5型,并对各种病理分型与低补体血症之间进行统计学分析。同时统计原发性IgA肾病中免疫病理C3在肾脏的沉积阳性率。结果原发性IgA肾病低补体C3血症与临床表现之间无明显关联,X2检验无显著性差异(X2=3.106,p>0.05)。但低补体C3血症与病理类型存在统计学差异(X2=10.165,p<0.05)。免疫病理C3在肾内沉积阳性率77%。结论原发性IgA肾病可发生低补体血症,其发生率与病理类型有关,WHO分型Ⅱ型及Ⅳ型低补体C3血症发生率较高,提示原发性IgA肾病发病过程存在着明显的补体消耗,临床上遇见低补体C3血症亦不能完全排除原发性IgA肾病,仍需考虑原发性IgA肾病的可能。
Objective To investigate the relationship between primary IgA nephropathy and hypocomplementemia. Methods From January 2006 to June 2009, 154 cases of IgA nephropathy were diagnosed by percutaneous renal biopsy, and secondary factors such as lupus nephritis and hepatitis B-related nephritis were excluded. Analysis of its complement C3 concentration, of which 41 cases of low complement C3 hyperlipidemia, accounting for 26.6% incidence of primary IgA nephropathy, a variety of clinical manifestations and hypocomplementemia were statistically analyzed. Pathological type according to WHO sub-type 5, and a variety of pathological type and hypo-hyperlipidemia between statistical analysis. At the same time, primary IgA nephropathy immunopathology C3 in the deposition of positive rates in the kidney. Results Primary IgA nephropathy was not associated with clinical manifestations of low complement C3 hyperlipidemia. There was no significant difference between the two groups (χ2 = 3.106, p> 0.05). However, there was a significant difference between low complement C3 hyperlipidemia and pathological types (X2 = 10.165, p <0.05). Immunopathology C3 in the kidney deposition rate of 77%. Conclusions Primary IgA nephropathy can occur hypocomplementemia, the incidence of which is related to the pathological type. The incidence of type Ⅱ and Ⅳ low complement C3 hyperlipidemia in WHO is high, suggesting that the pathogenesis of primary IgA nephropathy is obvious Of complement consumption, clinical encounter low complement C3 hyperlipidemia can not completely rule out primary IgA nephropathy, still need to consider the possibility of primary IgA nephropathy.