目的 探讨肾小管间质损害在儿童IgA肾病中的临床意义.方法 分析住院的IgA肾病患儿的临床与病理资料,探讨IgA肾病患儿的肾小管间质损害与临床、实验室指标及其他病理参数的关系.结果 98例符合IgA肾病诊断标准的患儿中,23例未见肾小管间质损害,56例患儿存在肾小管间质轻度损害,19例存在重度损害.与无肾小管间质损害的患儿比较,肾小管间质损害患儿的病情加重,表现为血清白蛋白水平下降和血肌酐及尿素氮水平增高(P＜0.05).病理可见随着肾小管间质损害程度的加重,肾小球损害程度亦加重,表现为肾小球硬化发生率逐渐增多,以及评价肾小球总体损害的积分逐渐增高(P＜0.05).结论 IgA肾病患儿的肾小管间质损害与肾小球病变程度相平行,随着肾小管间质损害程度的加重,IgA肾病患儿的病情亦逐渐加重,提示肾小管间质损害与肾小球病变直接相关,肾小管间质损害可能是影响儿童IgA肾病预后不良的因素之一.%Objective To explore the clinical significance of tubule-interstitial lesions (TIL) in children with IgA nephropathy. Methods 98 children with biopsy-proven IgA nephropathy were enrolled in this study, 56 with mild TIL, 19 with severe, and 23 without TIL. Data regarding clinical and laboratory features were obtained. Semi-quantitative scores for glomerular and tubulointerstitial damage were used to evaluate renal histological lesions. Results There was a significant decrease in serum creatinine and urea nitrogen, but an increase in serum albumin, in patients with TIL compared with patients without TIL. TIL was significantly associated with increased severity of glomerular damage. Conclusion TIL correlates well with clinical and histological features in children with IgA nephropathy, which suggests TIL may be one of the factors that predispose children with IgA nephropathy to develop into end-stage renal failure.
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