摘要
目的探讨IgA肾病合并高尿酸血症患者的临床及病理变化的特点,以期揭示IgA肾病伴有高尿酸血症的临床意义。方法回顾性分析2006年6月至2012年12月厦门大学附属中山医院肾内科收治的270例经肾活检确诊的原发性IgA肾病患者,依据血尿酸水平,将270例IgA肾病患者分为高尿酸血症组和尿酸正常组,测定记录所有患者的性别、发病年龄、收缩期血压、24 h尿蛋白定量、血尿酸、血肌酐、血白蛋白、血脂等临床指标,所有患者均进行肾脏病理检查并行Lee分级,统计分析2组的临床和病理特点,并对肾功能正常患者(135例)的病理指标进一步行亚组分析。结果IgA肾病患者高尿酸血症的患病率为25.19%,高尿酸血症组患者年龄、血白蛋白、血三酰甘油、血清总胆固醇水平与尿酸正常组比较,差异无统计学意义,患者男性比例、收缩期血压、24 h尿蛋白定量、血肌酐水平均高于尿酸正常组(P<0.05),高尿酸血症组患者肾脏病理Lee分级严重的比例及发生肾小管间质病变、肾内动脉病变的比例均高于尿酸正常组(P<0.05)。正常肾功能患者中,高尿酸血症组出现动脉壁肥厚等肾内动脉病变及肾小管间质慢性病变的比例亦高于尿酸正常组(P<0.05)。结论 IgA肾病合并高尿酸血症患者与尿酸正常组患者比较,临床表现及肾脏病理损伤多较重,尤其对肾小管间质病变及肾内血管病变影响更明显,临床预后不佳,应予重视并及时有效地进行干预治疗。
Objective To investigate the clinicopathological characteristics of IgA nephropathy combined with hyperuricemia in order to reveal the clinical significance of IgA nephropathy associated with hyperuricemia. Methods We retrospectively reviewed the clinical data of 270 patients with IgA nephropathy diagnosed by renal biopsy from June 2006 to December 2012. The patients were divided into the two groups： IgA nephropathy patients with or without hyperuricemia. The sex, age, systolic blood pressure, 24-h urine protein, serum uric acid, and serum creatinine were measured. All patients underwent renal pathological examination and Lee＇s classification. A comparative analysis of clinical manifestations and renal pathological injuries was performed between the two groups, and the patho- logical parameters of patients with normal renal function were further analyzed. Results The prevalence of hyperuricemia in patients with IgA nephropathy was 25.19%. The systolic blood pressure, 24-h urine protein and serum creatinine level were higher in the hyperuricemia group than in the normal group. The renal pathological changes in the hyperuricemia group were more severe than those in the normal uric acid group. The proportion of renal tubular interstitial lesions and renal artery lesions in the hyperuricemia group was higher than in the normal renal function group. The proportion of renal artery stenosis and renal tubular interstitial chronic lesions in the patients with hyperuricemia group was higher than in normal serum uric acid group. Conclusions The clinical manifestations and renal pathological changes of patients with IgA nephropathy combined with hyperuricemia are more serious than those with normal serum uric acid level, in particular, the effects of renal tubular interstitial lesions and renal vascular lesions were more obvious, and the clinical prognosis is not good. Timely and effective treatments are needed.
出处
《临床肾脏病杂志》
2016年第3期152-156,共5页
Journal Of Clinical Nephrology
关键词
IGA肾病
尿酸
尿蛋白
IgA nephropathy
Uric acid
Urine protein
