CAJ | 학술논문

目的：研究银屑病患者肾脏功能的变化情况。方法：53例银屑病患者，其中男38例，女15例，平均年龄（46±12）岁，以年龄和性别相匹配的健康者53例个体为对照组。用银屑病皮损面积和严重程度指数（PASI）评估银屑病的严重程度。所有患者及对照组均行尿液分析包括尿常规及尿沉渣镜检、24 h尿蛋白定量及尿微量白蛋白。其中尿微量白蛋白>30 mg/L认为病理性白蛋白尿，对尿液检查异常的银屑病患者进行肾活检。结果：①银屑病患者和对照组的尿常规分析及镜检差异均无统计学意义（P＞0.05）；两组间的平均24 h蛋白尿、尿微量白蛋白差异均无统计学意义（P＞0.05）；但与对照组相比，银屑病患者病理性白蛋白尿的发生率显著增加（分别为24%和2%，P＜0.01）。②银屑病患者的PASI分数与24 h白蛋白尿显著相关（r=0.458，P＜0.01）。其中9例银屑病患者有肾功能异常，4例进行了肾活检，证实2例为肾小球肾炎，且均为系膜增殖性肾小球肾炎。结论：银屑病患者中肾脏异常并不常见，而病理性白蛋白尿发生率显著增加，且与银屑病的严重程度相关，提示银屑病患者可能存在早期肾功能损害。
목적：연구은설병환자신장공능적변화정황。방법：53례은설병환자，기중남38례，녀15례，평균년령（46±12）세，이년령화성별상필배적건강자53례개체위대조조。용은설병피손면적화엄중정도지수（PASI）평고은설병적엄중정도。소유환자급대조조균행뇨액분석포괄뇨상규급뇨침사경검、24 h뇨단백정량급뇨미량백단백。기중뇨미량백단백>30 mg/L인위병이성백단백뇨，대뇨액검사이상적은설병환자진행신활검。결과：①은설병환자화대조조적뇨상규분석급경검차이균무통계학의의（P＞0.05）；량조간적평균24 h단백뇨、뇨미량백단백차이균무통계학의의（P＞0.05）；단여대조조상비，은설병환자병이성백단백뇨적발생솔현저증가（분별위24%화2%，P＜0.01）。②은설병환자적PASI분수여24 h백단백뇨현저상관（r=0.458，P＜0.01）。기중9례은설병환자유신공능이상，4례진행료신활검，증실2례위신소구신염，차균위계막증식성신소구신염。결론：은설병환자중신장이상병불상견，이병이성백단백뇨발생솔현저증가，차여은설병적엄중정도상관，제시은설병환자가능존재조기신공능손해。
To evaluated the prevalence of renal abnormalities in patients with psoriasis. Methods: Fifty-three pso-riasis patients [38 men, 15 women, mean age was (46±12)years old] and 53 age -gender matched control subjects without hypertension or diabetes were enrolled in the study. Psoriasis area and severity index (PASI) was used to assess the severity of psoriasis. Routine urine test, microscopic evaluation, 24 hours proteinuria and albuminuria were measured in all patients and controls. Pathologic albuminuria was difined as albumin excretion of more than 30 mg/L. Renal biopsy was performed in psoria-sis patients with urinary abnormalities. Results: Patients with psoriasis and controls were not significantly different with respect to the prevalence of abnormal urinalysis (P>0.05), mean 24 hours proteinuria (P>0.05) and albuminuria (P>0.05). However, patients with psoriasis had an increased prevalence of pathologic albuminuria compared with controls (24% vs 2%, P<0.005). PASI scores in psoriasis patients correlated significantly with albuminuria (r=0.458, P<0.01). Nine patients with psoriaisis had urinary abnormalities, four underwent renal biopsy. Two of them had biopsy-proven mesangial proliferative glomerulonephritis. Conclusion: The presence of abnormal urinalysis isn’t common in patients with psoriasis. However, the increased prevalence of pathologic albuminuria and its positive correlation with psoriasis severity may suggest subclinical glomerular dysfunction in these patients.