中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2011年
8期
659-663
,共5页
崔明姬%张宝红%肖庆飞%朱付莲%王红月
崔明姬%張寶紅%肖慶飛%硃付蓮%王紅月
최명희%장보홍%초경비%주부련%왕홍월
尿酸%肾小球肾炎,IgA%临床病理学
尿痠%腎小毬腎炎,IgA%臨床病理學
뇨산%신소구신염,IgA%림상병이학
Uric acid%Glomerulonephritis,IgA%Pathology,clinical
目的 探讨高尿酸血症与IgA肾病临床病理的相关性.方法 选取2007年1月至2010年12月在吉林大学第一医院肾内科肾活检确诊为IgA肾病患者148例,根据血尿酸水平分为血尿酸正常组(107例)和血尿酸增高组(41例),并对两组年龄、性别、高血压、病程、体重指数、生化指标及病理情况进行比较.结果 二组患者间性别、年龄等差异均无统计学意义(P>0.05).血尿酸增高组患者高血乐发病率、病程(月)、体重指数(kg/m2)、血尿素氮(mmol/L)、肌酐(μmol/L)、TG (mmol/L)及24 h尿蛋白定量(mg/24 h)分别为63.4%、18.90 ±10.12、22.81±3.60、8.93±4.28、155.96±107.72、2.11±1.06和4328.16±1434.25,而血尿酸止常组分别为38.3%、9.46±3.91、15.32±2.54、5.21±2.18、79.52±40.01、1.86±1.20和2885.10±1388.15,两组患者差异均有统计学意义(P值均<0.05).Lee's分级血尿酸增高组I+Ⅱ级占12.2%、IV+V级占39.0%,而血尿酸正常组I+Ⅱ级占25.2%、IV+V级占16.9%,两组患者差异均有统计学意义(P值均<0.05).肾小管间质损害(TIL)分级血尿酸增高组以Ⅲ十Ⅳ级多见,占68.3%,而血尿酸正常组以Ⅱ级多见,占76.6%.肾小动脉病变分级血尿酸增高组以Ⅱ+Ⅲ级多见,占73.2%,而血尿酸止常组以0+I级多见,占69.2%.结论 IgA肾病患者血尿酸水平与24 h尿蛋白定量、血压、肾功能损害相关,血尿酸升高者Lee's分级、TIL分级及肾小动脉病变分级较差.
目的 探討高尿痠血癥與IgA腎病臨床病理的相關性.方法 選取2007年1月至2010年12月在吉林大學第一醫院腎內科腎活檢確診為IgA腎病患者148例,根據血尿痠水平分為血尿痠正常組(107例)和血尿痠增高組(41例),併對兩組年齡、性彆、高血壓、病程、體重指數、生化指標及病理情況進行比較.結果 二組患者間性彆、年齡等差異均無統計學意義(P>0.05).血尿痠增高組患者高血樂髮病率、病程(月)、體重指數(kg/m2)、血尿素氮(mmol/L)、肌酐(μmol/L)、TG (mmol/L)及24 h尿蛋白定量(mg/24 h)分彆為63.4%、18.90 ±10.12、22.81±3.60、8.93±4.28、155.96±107.72、2.11±1.06和4328.16±1434.25,而血尿痠止常組分彆為38.3%、9.46±3.91、15.32±2.54、5.21±2.18、79.52±40.01、1.86±1.20和2885.10±1388.15,兩組患者差異均有統計學意義(P值均<0.05).Lee's分級血尿痠增高組I+Ⅱ級佔12.2%、IV+V級佔39.0%,而血尿痠正常組I+Ⅱ級佔25.2%、IV+V級佔16.9%,兩組患者差異均有統計學意義(P值均<0.05).腎小管間質損害(TIL)分級血尿痠增高組以Ⅲ十Ⅳ級多見,佔68.3%,而血尿痠正常組以Ⅱ級多見,佔76.6%.腎小動脈病變分級血尿痠增高組以Ⅱ+Ⅲ級多見,佔73.2%,而血尿痠止常組以0+I級多見,佔69.2%.結論 IgA腎病患者血尿痠水平與24 h尿蛋白定量、血壓、腎功能損害相關,血尿痠升高者Lee's分級、TIL分級及腎小動脈病變分級較差.
목적 탐토고뇨산혈증여IgA신병림상병리적상관성.방법 선취2007년1월지2010년12월재길림대학제일의원신내과신활검학진위IgA신병환자148례,근거혈뇨산수평분위혈뇨산정상조(107례)화혈뇨산증고조(41례),병대량조년령、성별、고혈압、병정、체중지수、생화지표급병리정황진행비교.결과 이조환자간성별、년령등차이균무통계학의의(P>0.05).혈뇨산증고조환자고혈악발병솔、병정(월)、체중지수(kg/m2)、혈뇨소담(mmol/L)、기항(μmol/L)、TG (mmol/L)급24 h뇨단백정량(mg/24 h)분별위63.4%、18.90 ±10.12、22.81±3.60、8.93±4.28、155.96±107.72、2.11±1.06화4328.16±1434.25,이혈뇨산지상조분별위38.3%、9.46±3.91、15.32±2.54、5.21±2.18、79.52±40.01、1.86±1.20화2885.10±1388.15,량조환자차이균유통계학의의(P치균<0.05).Lee's분급혈뇨산증고조I+Ⅱ급점12.2%、IV+V급점39.0%,이혈뇨산정상조I+Ⅱ급점25.2%、IV+V급점16.9%,량조환자차이균유통계학의의(P치균<0.05).신소관간질손해(TIL)분급혈뇨산증고조이Ⅲ십Ⅳ급다견,점68.3%,이혈뇨산정상조이Ⅱ급다견,점76.6%.신소동맥병변분급혈뇨산증고조이Ⅱ+Ⅲ급다견,점73.2%,이혈뇨산지상조이0+I급다견,점69.2%.결론 IgA신병환자혈뇨산수평여24 h뇨단백정량、혈압、신공능손해상관,혈뇨산승고자Lee's분급、TIL분급급신소동맥병변분급교차.
objective To analyze the correlation between the level of serum uric acid and the clinical and pathological features of IgA nephropathy.Methods Totally 148 patients diagnosed as IgA nephropathy by renal biopsy in our hospital from January 2007 to December 2010 were divided into hyperuricaemic group(41 cases)and non-hyperuricaemic group(107 cases)according to the level of serum uric acid.The clinical parameters and renal pathology grade were compared.Results There were significant differences between hyperuricaemic group and non-hyperuricaemic group in the incidences of hypertension(63.4%vs 38.3%),disease duration[(18.90±10.12)months vs(9.46±3.91)months]and body mass index[(22.81±3.60)kg/m2vs(15.32±2.54)kg/m2](all P<0.05),while no differences in age and sex(both P>0.05).The blood urea nitrogen(BUN)[(8.93±4.28)mmol/L vs (5.21±2.18)mmol/L],creatinine(Cr)[(155.96±107.72)μmol/L vs(79.52±40.01)μmol/L],serum triglycerides[(2.11±1.06)mmoVL vs(1.86±1.20)mmol/L]and 24-hour urine protein amount [(4328.16±1434.25)mg/24 h vs(2885.10±1388.15)mg/24 h]were significantly different between the two groups(all P<0.05).The percentage of Lee's grade I+Ⅱin hyperuricaemic group was 12.2%,and IV+V grade was 39.0%,while percentage of Lee's grade I+Ⅱin non-hyperuricaemic group was 25.2%,and IV+V grade was 16.9%(P<0.05).Tubulointerstitial lesions(TIL)gradeⅢ+IV was more in hyperuricaemic group,which was 68.3%,while TIL grade II was more in non-hyperuricaemic group,which was 76.6%.Renal artery damage grade II+Ⅲ was more in hyperuricaemic group.which was 73.2%,while renal artery damage grade 0+1 was more in non-hyperuricaemic group,which was 69.2%.Conclusion The level of serum uric acid was related with 24-hour urine protein amount,blood pressure and kidney function in IgA nephropathy,and Lee's grade,TIL grade and renal artery damage grade were severe in hyperuricaemic group.
