中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2015年
14期
2669-2672
,共4页
刘擘%曾玉纯%李劲高%徐安平%宛霞
劉擘%曾玉純%李勁高%徐安平%宛霞
류벽%증옥순%리경고%서안평%완하
肾小球肾炎,IGA%高胆固醇血症%高甘油三酯血症
腎小毬腎炎,IGA%高膽固醇血癥%高甘油三酯血癥
신소구신염,IGA%고담고순혈증%고감유삼지혈증
Glomerulonephritis,IgA%Hypercholesteremia%Hypertriglyceridemia
目的:探讨IgA肾病中不同类型的血脂异常与高血压、蛋白尿、估算的肾小球滤过率(eGFR)等临床资料及肾脏病理的关系。方法本研究为回顾性分析,共纳入了264例经肾活检确诊的IgA肾病患者。记录活检前血压、24 h尿蛋白定量、eGFR、血脂等临床资料及活检后病理资料。分别比较伴不同血脂异常类型的IgA肾病的临床及病理特征。结果 IgA肾病伴高胆固醇血症者较胆固醇正常者更易于合并高血压(43.5% vs.25.7%,P=0.015),eGFR[(62.56±21.00) ml·min-1·(1.73 m2)-1 vs.(74.76±19.20)ml·min-1·(1.73 m2)-1,P<0.001]及血白蛋白水平[(34.12±9.22)g/L vs.(40.74±3.27)g/L,P<0.001]更低,24 h尿蛋白量[1.57(0.47~3.84)g/24 h vs.0.28(0.11~0.70)g/24 h,P<0.001]更多。而IgA肾病合并高甘油三酯血症者则较甘油三酯正常者更容易倾向为男性(46.3% vs.29.5%,P=0.019),年龄更大[(38.6±12.3)岁 vs.(34.3±11.9)岁, P=0.017],也易发生高血压(46.3% vs.24.3%,P=0.001),24 h尿蛋白量[0.69(0.26~2.16)g/24 h vs.0.30(0.11~0.77)g/24 h,P=0.001]亦更大,并易发生肾间质纤维化(70.4% vs.45.7%,P=0.001)及肾小动脉病变(31.5% vs 18.6%,P=0.038)。血脂异常与肾脏病理Hass分级无明显相关性。结论高胆固醇血症与高甘油三酯血症加重IgA肾病的临床指标。而且,高甘油三酯血症是IgA肾病发生肾间质纤维化及肾小动脉病变的危险因素。
目的:探討IgA腎病中不同類型的血脂異常與高血壓、蛋白尿、估算的腎小毬濾過率(eGFR)等臨床資料及腎髒病理的關繫。方法本研究為迴顧性分析,共納入瞭264例經腎活檢確診的IgA腎病患者。記錄活檢前血壓、24 h尿蛋白定量、eGFR、血脂等臨床資料及活檢後病理資料。分彆比較伴不同血脂異常類型的IgA腎病的臨床及病理特徵。結果 IgA腎病伴高膽固醇血癥者較膽固醇正常者更易于閤併高血壓(43.5% vs.25.7%,P=0.015),eGFR[(62.56±21.00) ml·min-1·(1.73 m2)-1 vs.(74.76±19.20)ml·min-1·(1.73 m2)-1,P<0.001]及血白蛋白水平[(34.12±9.22)g/L vs.(40.74±3.27)g/L,P<0.001]更低,24 h尿蛋白量[1.57(0.47~3.84)g/24 h vs.0.28(0.11~0.70)g/24 h,P<0.001]更多。而IgA腎病閤併高甘油三酯血癥者則較甘油三酯正常者更容易傾嚮為男性(46.3% vs.29.5%,P=0.019),年齡更大[(38.6±12.3)歲 vs.(34.3±11.9)歲, P=0.017],也易髮生高血壓(46.3% vs.24.3%,P=0.001),24 h尿蛋白量[0.69(0.26~2.16)g/24 h vs.0.30(0.11~0.77)g/24 h,P=0.001]亦更大,併易髮生腎間質纖維化(70.4% vs.45.7%,P=0.001)及腎小動脈病變(31.5% vs 18.6%,P=0.038)。血脂異常與腎髒病理Hass分級無明顯相關性。結論高膽固醇血癥與高甘油三酯血癥加重IgA腎病的臨床指標。而且,高甘油三酯血癥是IgA腎病髮生腎間質纖維化及腎小動脈病變的危險因素。
목적:탐토IgA신병중불동류형적혈지이상여고혈압、단백뇨、고산적신소구려과솔(eGFR)등림상자료급신장병리적관계。방법본연구위회고성분석,공납입료264례경신활검학진적IgA신병환자。기록활검전혈압、24 h뇨단백정량、eGFR、혈지등림상자료급활검후병리자료。분별비교반불동혈지이상류형적IgA신병적림상급병리특정。결과 IgA신병반고담고순혈증자교담고순정상자경역우합병고혈압(43.5% vs.25.7%,P=0.015),eGFR[(62.56±21.00) ml·min-1·(1.73 m2)-1 vs.(74.76±19.20)ml·min-1·(1.73 m2)-1,P<0.001]급혈백단백수평[(34.12±9.22)g/L vs.(40.74±3.27)g/L,P<0.001]경저,24 h뇨단백량[1.57(0.47~3.84)g/24 h vs.0.28(0.11~0.70)g/24 h,P<0.001]경다。이IgA신병합병고감유삼지혈증자칙교감유삼지정상자경용역경향위남성(46.3% vs.29.5%,P=0.019),년령경대[(38.6±12.3)세 vs.(34.3±11.9)세, P=0.017],야역발생고혈압(46.3% vs.24.3%,P=0.001),24 h뇨단백량[0.69(0.26~2.16)g/24 h vs.0.30(0.11~0.77)g/24 h,P=0.001]역경대,병역발생신간질섬유화(70.4% vs.45.7%,P=0.001)급신소동맥병변(31.5% vs 18.6%,P=0.038)。혈지이상여신장병리Hass분급무명현상관성。결론고담고순혈증여고감유삼지혈증가중IgA신병적림상지표。이차,고감유삼지혈증시IgA신병발생신간질섬유화급신소동맥병변적위험인소。
Objective To investigate the association between lipid disorders and the clinical and pathological features in patients with IgA nephropathy (IgAN). Methods A total of 264 patients with biopsy-proven IgAN were enrolled. Clinical data such as blood pressure, 24-hour urine protein amount, eGFR and blood lipid level were recorded before biopsy and pathological data were recorded after biopsy. We tried to identify the clinical and pathological features of IgAN with different types of lipid disorders. Results Compared to the IgAN patients with normal cholesterol, those with hypercholesteremia had a significantly higher prevalence of hypertension (43.5% vs. 25.7%, P=0.015), lower level of eGFR [(62.56±21.00)ml·min-1·(1.73 m2)-1 vs. (74.76±19.20)ml·min-1·(1.73 m2)-1, P<0.001] and albumin [(34.12±9.22)g/L vs. (40.74±3.27)g/L, P<0.001], and higher level of 24-hour urine protein amount [1.57(0.47-3.84)g/24 h vs. 0.28 (0.11-0.70)g/24 h, P<0.001]. It revealed significantly more male (46.3% vs. 29.5%, P=0.019), older age [(38.6±12.3)years vs. (34.3±11.9)years, P=0.017], higher prevalence of hypertension (46.3% vs. 24.3%, P=0.001) and higher level of 24-hour urine protein amount [0.69(0.26-2.16)g/24 h vs. 0.30 (0.11-0.77)g/24 h, P=0.001] in hypertriglyceridaemia group. Meanwhile they were more likely to develop renal interstitial fibrosis (70.4% vs. 45.7%, P=0.001) and renal arteriolar lesion (31.5% vs. 18.6%, P=0.038). There was no relationship between lipid disorders and Hass degree. Conclusions Both hypercholesteremia and hypertriglyceridemia together are worse to the clinical parameters of IgAN. Moreover, hypertriglyceridaemia is a risk factor of renal interstitial fibrosis and renal arteriolar lesion in IgAN patients.