116例增生硬化性IgA肾病患者的临床及病理特点分析(1)
[摘要] 目的 探討增生硬化性IgA肾病患者的临床及病理特点。 方法 回顾性分析2015年1月—2019年3月就诊于中国中医科学院西苑医院肾病科门诊并经肾活检证实为增生硬化性IgA肾病患者116例。根据慢性肾脏病(CKD)分期将其分为CKD 1～5期，比较各组24 h尿蛋白定量及合并症情况(包括有无高血压、高尿酸血症等);根据有无缺血性肾损伤分为伴缺血性肾损伤组和不伴缺血性肾损伤组，根据有无IgM沉积分为伴IgM沉积组和不伴IgM沉积组，比较各组的24小时尿蛋白定量、血肌酐水平及估算的肾小球滤过率(eGFR)。 结果 五组年龄，24 h尿蛋白定量，高尿酸血症、咽炎及扁桃体炎占比比较，差异均有统计学意义(均P < 0.05)。伴缺血性肾损伤组血肌酐、高血压占比高于不伴缺血性肾损伤组，eGFR低于不伴缺血性肾损伤组，差异均有统计学意义(均P < 0.05)。伴IgM沉积组年龄、eGFR水平低于不伴IgM沉积组，血肌酐水平高于不伴IgM沉积组，差异均有统计学意义(均P < 0.05)。 结论 增生硬化性IgA肾病患者临床与病理损伤较重，24 h尿蛋白定量、血肌酐、缺血性肾损伤及IgM沉积可能是其肾功能进展及肾脏预后不良的危险因素。
[关键词] 增生硬化性IgA肾病;临床特点;病理特点;血肌酐;预后
[中图分类号] R692 [文献标识码] A [文章编号] 1673-7210(2020)10(a)-0096-04
Clinical and pathological features of 116 patients with proliferative and sclerosing IgA nephropathy
CHANG Meiying ZHANG Yu
Department of Nephropathy， Xiyuan Hospital， China Academy of Chinese Medical Sciences， Beijing 100091， China
[Abstract] Objective To investigate the clinical and pathological features of patients with proliferative and sclerosing IgA nephropathy. Methods Retrospective analysis was performed on 116 patients with proliferative and sclerosing IgA nephropathy confirmed by renal biopsy in Department of Nephropathy， Xiyuan Hospital， China Academy of Chinese Medical Sciences from January 2015 to March 2019. According to chronic kidney diseases (CKD) stage， they were divided into CKD stage 1-5. The 24 h urinary protein quantification and comorbidities of each group were compared (including the presence or absence of hypertension， hyperuricemia， etc.). They were divided into group with ischemic kidney injury and group without ischemic kidney injury according to the presence or absence of ischemic kidney injury， and they were divided into group with IgM deposition and group without IgM deposition according to the presence or absence of IgM deposition group. The 24 h urinary protein quantification， serum creatinine level and estimated glomerular filtration rate (eGFR) of each group were compared. Results There were statistically significant differences among the five groups in age， 24 h urine protein quantification， and proportion of hyperuricemia， pharyngitis and tonsillitis (all P < 0.05). The serum creatinine and proportion of hypertension in group with ischemic kidney injury were higher than those of the group without ischemic kidney injury， and eGFR was lower than that of the group without ischemic kidney injury， with statistically significant differences (all P < 0.05). The age and eGFR level of group with IgM deposition were lower than those of group without IgM deposition， the serum creatinine level was higher than that of group without IgM deposition， and the differences were statistically significant (all P < 0.05). Conclusion The clinical and pathological lesions in patients with proliferation and sclerosing IgA nephropathy are severe， and 24 h urine protein quantitative， blood creatinine， ischemic kidney injury and IgM deposition may be risk factors for renal progression and poor renal prognosis., http://www.100md.com(常美莹 张昱)
[关键词] 增生硬化性IgA肾病;临床特点;病理特点;血肌酐;预后
[中图分类号] R692 [文献标识码] A [文章编号] 1673-7210(2020)10(a)-0096-04
Clinical and pathological features of 116 patients with proliferative and sclerosing IgA nephropathy
CHANG Meiying ZHANG Yu
Department of Nephropathy， Xiyuan Hospital， China Academy of Chinese Medical Sciences， Beijing 100091， China
[Abstract] Objective To investigate the clinical and pathological features of patients with proliferative and sclerosing IgA nephropathy. Methods Retrospective analysis was performed on 116 patients with proliferative and sclerosing IgA nephropathy confirmed by renal biopsy in Department of Nephropathy， Xiyuan Hospital， China Academy of Chinese Medical Sciences from January 2015 to March 2019. According to chronic kidney diseases (CKD) stage， they were divided into CKD stage 1-5. The 24 h urinary protein quantification and comorbidities of each group were compared (including the presence or absence of hypertension， hyperuricemia， etc.). They were divided into group with ischemic kidney injury and group without ischemic kidney injury according to the presence or absence of ischemic kidney injury， and they were divided into group with IgM deposition and group without IgM deposition according to the presence or absence of IgM deposition group. The 24 h urinary protein quantification， serum creatinine level and estimated glomerular filtration rate (eGFR) of each group were compared. Results There were statistically significant differences among the five groups in age， 24 h urine protein quantification， and proportion of hyperuricemia， pharyngitis and tonsillitis (all P < 0.05). The serum creatinine and proportion of hypertension in group with ischemic kidney injury were higher than those of the group without ischemic kidney injury， and eGFR was lower than that of the group without ischemic kidney injury， with statistically significant differences (all P < 0.05). The age and eGFR level of group with IgM deposition were lower than those of group without IgM deposition， the serum creatinine level was higher than that of group without IgM deposition， and the differences were statistically significant (all P < 0.05). Conclusion The clinical and pathological lesions in patients with proliferation and sclerosing IgA nephropathy are severe， and 24 h urine protein quantitative， blood creatinine， ischemic kidney injury and IgM deposition may be risk factors for renal progression and poor renal prognosis., http://www.100md.com(常美莹 张昱)