摘要
目的探讨肾小球内补体C4d沉积对免疫球蛋白A(immunoglobulin A,IgA)肾病预后的影响。方法选取2010年2月至2016年5月四川省简阳市人民医院肾内科收治的IgA肾病患者146例。根据补体C4d在肾小球内沉积情况将患者分为阳性组(75例)和阴性组(71例),比较两组临床及随访资料。采用Kaplan-Meier法对两组患者终点事件的发生时间进行分析;采用Cox比例风险回归模型分析发生终点事件的独立危险因素。结果阳性组血肌酐、血尿酸、24h尿蛋白、血清IgA、血清C4d高于阴性组,估算滤过率低于阴性组(P<0.05);两组牛津分型(M、S、T分级)比较差异有显著性(P<0.05);阳性组终点事件发生率高于阴性组(P<0.05);Kaplan-Meier分析结果显示,阳性组终点事件发生时间短于阴性组(P<0.05);多因素Cox回归分析显示,肾小球内补体C4d沉积阳性是影响IgA肾病预后的独立危险因素(P<0.05)。结论肾小球内补体C4d沉积与IgA肾病患者预后较差相关,可作为判断患者预后不良的标志物。
Objective To explore the effect of glomerular C4 d deposition on the prognosis of IgA nephropathy.Method 146 IgA nephropathy patients admitted to the Department of Nephrology of the People’s Hospital of Jianyang from February 2010 to May 2016 were selected as the study object.According to the glomerular C4 d deposition,the patients were divided into positive group and negative group.The clinical and follow-up data of the two groups were compared.Kaplan-Meier method was used to analyze the occurrence time of terminal events between the two groups.Cox proportional risk regression model was used to analyze the independent risk factors of terminal events.Result The level of creatinine,uric acid,24 h urinary protein,IgA,C4 d in the positive group were higher than those in the negative group,and the eGFR was lower than that in the negative group(P<0.05).There was significant difference in Oxford classification(M,S,T grading)between the two groups(P<0.05).The incidence of the terminal events in the positive group was higher than that in the negative group(P<0.05).Kaplan-Meier analysis showed that the time of the terminal event in positive group was shorter than that in negative group(P<0.05).Multivariate Cox regression analysis showed that the positive deposition of glomerular C4 d was an independent risk factor for the prognosis of IgA nephropathy(P<0.05).Conclusion The glomerular C4 d deposition was related to the poor prognosis of IgA nephropathy,which could be used as a marker to judge the poor prognosis of IgA nephropathy.
作者
王明莉
陈德政
Wang Mingli;Chen Dezheng(Department of Nephrology,the People’s Hospital of Jianyang,Jianyang Sichuan 641400,China)
出处
《中国临床医生杂志》
2020年第8期912-916,共5页
Chinese Journal For Clinicians
关键词
免疫球蛋白A
肾病
补体C4d沉积
预后
Immunoglobulin A
Nephropathy
Compliment C4d deposition
Prognosis
