摘要
目的探讨伴有血脂异常的老年慢性肾小球肾炎CKD1-2期患者临床及病理特点,以评估血脂异常对慢性肾脏病的影响。方法纳入2014年至2017年首次行肾活检诊断并符合CKD1-2期原发性慢性肾小球肾炎的老年患者111例,根据有无高脂血症分为高脂血症组(HL组,76例)和非高脂血症组(非HL组,35例),回顾分析两组患者的一般资料、临床及病理特点。结果(1)两组患者年龄、性别比、体质指数、高血压患病率、病理分布类型、血肌酐、高敏C反应蛋白等差异无统计学意义。HL组的血尿酸水平、24 h尿蛋白定量、尿转铁蛋白、尿白蛋白、尿α1微球蛋白、尿NAG酶均高于非HL组,血清白蛋白低于非HL组(P<0.05);(2)HL组血管损伤评分高于非HL组(P<0.05),而肾小球硬化比例、新月体比例、系膜增生、肾小管损伤等评分两组差异无统计学意义;(3)通过二元变量相关分析,24 h尿蛋白、尿转铁蛋白与血清胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白相关,血尿酸、尿白蛋白与与血清胆固醇、甘油三酯、低密度脂蛋白相关,血清白蛋白、尿NAG酶与血清胆固醇、甘油三酯、低密度脂蛋白相关。结论伴血脂异常的老年慢性肾小球肾炎CKD1-2期患者尿蛋白、肾小管损伤更重,肾微血管病变程度更高。
Aim To investigate the clinical and pathological features of chronic kidney disease(CKD)1-2 stage in chronic glomerulonephritis elderly patients with dyslipidemia,and to evaluate the effect of dyslipidemia on CKD.Methods A total of 111 elderly patients who underwent renal biopsy and were eligible for CKD1-2 with primary chronic glomerulonephritis from 2014 to 2017 were enrolled.According to the presence of hyperlipidemia,they were divided into hyperlipidemia group(HL Group)of 76 patients,and non-hyperlipidemia group(non-HL group)of 35 patients,the general data,clinical and pathological features of two groups were reviewed.Results(1)There were no significant differences in age,sex ratio,body mass index,prevalence of hypertension,pathological distribution,serum creatinine,and high-sensitivity C-reactive protein between the two groups.The levels of serum uric acid,24 h urine protein,urinary transferrin,urinary albumin,urinaryα1 microglobulin and urinary NAG were higher in the HL group than in the non-HL group,and serum albumin was lower than that in the non-HL group(P<0.05).(2)The vascular injury scores of HL group was higher than that of non-HL group(P<0.05),but the scores of glomerular sclerosis,proportion of crescent,mesangial hyperplasia and tubular injury were not statistically different.(3)By binary variable correlation analysis,24 h urine protein and urinary transferrin were associated with serum cholesterol,triglyceride,low density lipoprotein,and high density lipoprotein;blood uric acid and urinary albumin were associated with serum cholesterol,triglycerides and low density lipoprotein;serum albumin and urinary NAG enzymes were associated with serum cholesterol,triglycerides,and low-density lipoprotein.Conclusion The CKD 1-2 elderly patients with chronic glomerulonephritis associated with dyslipidemia are more likely to get more severe urinary protein and tubule injury,and have higher risk of getting renal microvascular disease.
作者
倪小秋
包自阳
朱彩凤
NI Xiaoqiu;BAO Ziyang;ZHU Caifeng(Guangxing Hospital Affiliated to Zhejiang Chinese Medical University&Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou,Zhejiang 310007,China)
出处
《中国动脉硬化杂志》
CAS
2020年第4期322-326,共5页
Chinese Journal of Arteriosclerosis
基金
浙江省医药卫生科技计划项目(2013KYA167)
浙江省中医药科技计划项目(2019ZB084)
浙江省朱彩凤名老中医专家传承工作室建设计划项目(GZS2017013)。
关键词
老年人
血脂异常
慢性肾小球肾炎
慢性肾脏病1-2期
肾微血管损伤
elderly
dyslipidemia
chronic glomerulonephritis
chronic kidney disease 1-2 stage
renal microvascular injury
