CAJ | 학술논문

目的：探讨IgA肾病高尿酸血症与肾脏病理牛津分型、组织病理学及临床特征的关系。方法收集151例IgA肾病,将其分为血尿酸升高组与血尿酸正常组,对肾脏病理切片进行牛津分型、Lee氏分级和肾小球硬化、新月体及血管病变分析,并记录一般资料、血压、肾功能、尿蛋白等临床指标。结果151例中IgA肾病,高尿酸血症的发病率为48.3%,青壮年男性易发,高血压与高尿酸血症密切相关。肾脏病理牛津分型主要表现为M1E0S1T0,Lee氏分级主要表现为Ⅲ级,伴高尿酸血症患者肾脏病理突出表现为肾小管间质慢性化病变重,肾小球硬化比例增多,伴有肾小球滤过率下降,而血管病变差异不明显。结论 IgA肾病伴高尿酸血症发病率高,牛津分型显示伴有高尿酸血症的IgA肾病其肾小管间质慢性病变更明显,伴有肾小球滤过率下降,临床表现更重。
목적：탐토IgA신병고뇨산혈증여신장병리우진분형、조직병이학급림상특정적관계。방법수집151례IgA신병,장기분위혈뇨산승고조여혈뇨산정상조,대신장병리절편진행우진분형、Lee씨분급화신소구경화、신월체급혈관병변분석,병기록일반자료、혈압、신공능、뇨단백등림상지표。결과151례중IgA신병,고뇨산혈증적발병솔위48.3%,청장년남성역발,고혈압여고뇨산혈증밀절상관。신장병리우진분형주요표현위M1E0S1T0,Lee씨분급주요표현위Ⅲ급,반고뇨산혈증환자신장병리돌출표현위신소관간질만성화병변중,신소구경화비례증다,반유신소구려과솔하강,이혈관병변차이불명현。결론 IgA신병반고뇨산혈증발병솔고,우진분형현시반유고뇨산혈증적IgA신병기신소관간질만성병변경명현,반유신소구려과솔하강,림상표현경중。
Purpose To investigate the clinical characteristics and Oxford classification of IgA nephropathy patients with hyperurice-mia. Methods 151 IgA nephropathy patients confirmed by renal biopsy in 2013 were analyzed retrospectively. The patients were di-vided into the two groups:IgA nephropathy patients with or without hyperuricemia. Morphological changes were evaluated with Oxford classification scoring system and Lee’s grades. A comparative analysis of clinical manifestations and pathological injuries was performed between the two groups. Results Incidence of hyperuricemia in IgA nephropathy patients was 48. 3% and was more common in young men. Hypertension was associated with hyperuricemia. Oxford classification of IgA nephropathy patients with hyperuricemia was pre-dominant M1E0S1T0 and Lee’s grades presented with grade Ⅲ. The outstanding histopathologic features with higher plasma uric acid levels indicated higher tubulointerstitial chronicity, higher glomerular sclerosis ratio, accompanied by a decline in glomerular filtration rate. There was no significant difference of vascular lesions. Conclusions The prevalence of hyperuricemia in IgA nephropathy pa-tients is high. Oxford classification shows IgA nephropathy with hyperuricemia are associated with more severe tubulointerstitial lesions and lower GFR.