摘要
目的 探讨不同蛋白尿水平的原发性IgA肾病患者临床及病理特征.方法 选取2010年1月-2021年12月石河子大学医学院第一附属医院经肾活检诊断为IgA肾病患者204例,根据24 h尿蛋白定量水平将患者分为4组:＜0.3 g/d(A组,48例)、0.3～0.99 g/d(B组,67例)、1～1.99 g/d(C组,43例)、≥2 g/d(D组,46例).比较四组临床资料,并采用Spearman相关分析尿蛋白定量与临床指标的关系,采用Kaplan-Meier曲线分析肾脏累积生存率.结果 ①四组白蛋白(ALB)、总蛋白(TP)、肌酐(Scr)、尿素氮(BUN)、估算肾小球滤过率(eGFR)、总胆固醇(TC)、血清IgG、牛津分级、WHO分型比较,差异有统计学意义(P＜0.05);②Spearman相关分析显示,随着ALB、TP、eGFR、IgG降低及Scr、BUN、TC升高,24 h尿蛋白定量水平增加;③Kaplan-Meier曲线分析显示,A组肾脏累积生存率较B组、C组、D组高,D组较B组、C组低.结论 IgA肾病病理分级与临床指标间存在密切联系,随着尿蛋白定量的增加,IgA肾病患者肾功能减退、病理改变损害程度加重、肾脏累积生存率下降.
Abstract
Objective To investigate the clinical and pathological features of primary IgA nephropathy patients with different proteinuria levels.Methods A total of 204 patients with IgA nephropathy diagnosed by renal biopsy in the First Affiliated Hospital of Shihezi University School of Medicine from January 2010 to December 2021 were selected.According to the level of 24-hour urinary protein quantification,the patients were divided into 4 groups:＜0.3 g/d(group A,48 patients),0.3-0.99 g/d(group B,67 patients),1-1.99 g/d(group C,43 patients),≥2 g/d(group D,46 patients).The clinical data of the four groups were compared,and the relationship between urinary protein quantification and clinical indicators was analyzed by Spearman correlation.Kaplan-Meier curve was used to analyze the cumulative survival rate of kidney.Results ①There were significant differences in albumin(ALB),total protein(TP),creatinine(Scr),urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),total cholesterol(TC),serum IgG,Oxford classification and WHO classification among the four groups(P＜0.05);②Spearman correlation analysis showed that with the decrease of ALB,TP,eGFR,IgG and the increase of Scr,BUN and TC,the quantitative level of 24-hour urine protein increased;③Kaplan-Meier curve analysis showed that the cumulative survival rate of kidney in group A was higher than that in group B,group C and group D,and the cumulative survival rate of kidney in group D was lower than that in group B and group C.Conclusion There is a close relationship between the pathological grade of IgA nephropathy and clinical indicators.With the increase of urinary protein quantification,the renal function of patients with IgA nephropathy decreases,the degree of pathological damage increases,and the cumulative survival rate of kidney decreases.
维普
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