CAJ | 학술논문

目的探讨肾小球疾病患者临床和病理学因素对高尿酸血症(HUA)患病率的影响.方法回顾性分析2007年1月至2011年12月间,经肾脏活检确诊的3547例肾小球疾病患者的临床和病理学资料,并进行统计学分析.结果 (1)在所有肾小球疾病患者中,HUA患病率为21.8％ (773/3547),其中继发性肾小球疾病27.2％(240/882)高于原发性的20.7％(552/2665),差异有统计学意义(x2=153.642,P＜0.05)；原发性肾小球疾病中膜性肾病HUA的患病率最低,为14.4％ (96/665)；继发性肾小球疾病中狼疮性肾炎HUA的患病率最高,为45.3％ (110/243),小血管炎肾损害[34.7％ (17/49)]次之.(2)随着肾小球硬化指数、肾小管间质积分、肾内血管病变积分和慢性肾脏病分期的增加,HUA患病率进行性增加(x2值为17.798～298.216,P均=0.000).(3)二项Logistic回归分析提示:肾小管间质积分和肾小球硬化指数高、肾功能减退、男性、超重或肥胖、高血压和高甘油三酯均是HUA的危险因素(OR为1.011～7.513,P均＜0.05).结论近1/4的肾小球疾病患者血尿酸升高；肾小管间质病变重、肾小球硬化指数高、肾小球滤过功能差、男性、超重或肥胖、高血压和高甘油三酯均是HUA的独立危险因素.
목적 탐토신소구질병환자림상화병이학인소대고뇨산혈증(HUA)환병솔적영향.방법 회고성분석2007년1월지2011년12월간,경신장활검학진적3547례신소구질병환자적림상화병이학자료,병진행통계학분석.결과 (1)재소유신소구질병환자중,HUA환병솔위21.8％ (773/3547),기중계발성신소구질병27.2％(240/882)고우원발성적20.7％(552/2665),차이유통계학의의(x2=153.642,P＜0.05)；원발성신소구질병중막성신병HUA적환병솔최저,위14.4％ (96/665)；계발성신소구질병중랑창성신염HUA적환병솔최고,위45.3％ (110/243),소혈관염신손해[34.7％ (17/49)]차지.(2)수착신소구경화지수、신소관간질적분、신내혈관병변적분화만성신장병분기적증가,HUA환병솔진행성증가(x2치위17.798～298.216,P균=0.000).(3)이항Logistic회귀분석제시:신소관간질적분화신소구경화지수고、신공능감퇴、남성、초중혹비반、고혈압화고감유삼지균시HUA적위험인소(OR위1.011～7.513,P균＜0.05).결론 근1/4적신소구질병환자혈뇨산승고；신소관간질병변중、신소구경화지수고、신소구려과공능차、남성、초중혹비반、고혈압화고감유삼지균시HUA적독립위험인소.
Objective To explore the effect of clinical and pathological features on the incidence of Hyperuricemia (HUA) in renal glomerular disease.Methods A retrospective analysis was applied to review the clinical and pathological date collected from 3547 patients with renal glomerular disease.These patients were diagnosed as renal glomerular disease by renal biopsy from January 2007 to December 2011.Results (1) HUA incidence was 21.8％ (773/3547) in all of the patients,in which the incidence in secondary glomerular disease 27.2％ (240/882) was much higher than that in primary glomerular disease 20.7％ (552/2665),and the difference was significant (x2 =153.642,P ＜ 0.05).In primary glomerular disease,HUA incidence was the lowest in membranous nephropathy 14.4％ (96/665),while HUA incidence in lupus nephritis (LN) 45.3％(110/243) was the highest and small blood vessel infammation kidney damage 34.7％ (17/49) was the second in secondary glomerular disease.(2) With the increasing of glomerulosclerosis index,tubulointerstitial score,renal vascular lesions score and the stage of chronic kidney disease,HUA incidence increased (x2 =17.798-298.216,P =0.000).(3)Logistic regression analysis showed that high tubulointerstitial score,glomerulosclerosis index and renal dysfunction,male,overweight or obese,hypertension and hypertriglyceridemia were risk factors for hyperuricemia (OR:1.011-7.513,P ＜ 0.05).Conclusion The uric acid level is increased in nearly a quarter of patients with renal glomerular disease.Severe tubulointerstitial lesion,high glomerulosclerosis index,low glomerular filtration rate,male,overweight or obese,hypertension and hypertiglyceridemia were independent risk factors for HUA.