摘要
目的:探究高尿酸血症对狼疮性肾炎(lupus nephritis,LN)患者临床病理及预后的影响。方法:回顾性分析2006年1月—2016年12月期间在广东省中医院经肾活检确诊的LN患者的临床和病理资料,根据尿酸水平分为高尿酸组及正常尿酸组,比较两组的临床病理特征及预后差异。结果:合并高尿酸血症LN患者的基线肌酐、尿素氮、胆固醇水平显著高于正常尿酸组患者,而估计肾小球滤过率、补体C3、高密度脂蛋白、血红蛋白明显较正常尿酸组低,病理方面,高尿酸组患者的系膜增生和毛细血管内皮增生程度、肾脏病理活动指数(AI)高于正常尿酸组患者(P<0.05);Kaplan-Meier曲线显示两组肾脏累积生存率差异无统计学意义(P>0.05);多因素Cox回归分析得出肌酐是LN患者预后的独立危险因素,而尿酸不是其独立危险因素。结论:伴高尿酸血症的LN患者临床病理表现更重,尿酸是LN患者肾脏预后的重要预测因子。
Objective:To explore the effect of hyperuricemia on the clinical and pathological features and prognosis of patients with lupus nephritis(LN).Methods:The clinical and pathological data of LN patients diagnosed by renal biopsy from January2006 to December 2016 was retrospectively analyzed.The patients were divided into two groups according to the presence of hyperuricemia.Clinical and pathological characteristics and prognosis were compared between the two groups.Results:The levels of baseline creatinine,urea nitrogen and cholesterol in patients suffered LN with hyperuricemia were significantly higher than those without hyperuricemia,while the estimated glomerular filtration rate,complement C3,high-density lipoprotein,and hemoglobin were significantly lower.In terms of pathology,the mesangial hyperplasia and capillary endothelial hyperplasia and renal pathological activity index(AI)in patients with hyperuricemia were worsen than those in normal uric acid group(P<0.05).Kaplan-Meier analysis showed that there was no significant difference in the cumulative survival rate of the two groups(P>0.05).Furthermore,multivariate Cox regression analysis concluded that the level of serum creatinine was an independent risk factor for poor prognosis of LN patientsL,whereas uric acid was not.Conclusion:LN patients with hyperuricemia have more severe clinical and pathological manifestations.In addition,uric acid is an important predictor of renal prognosis in patients with LN.
作者
顾叶文
李虎才
王立新
GU Yewen;LI Hucai;WANG Lixin(The Second Clinical College of Guangzhou University of Chinese Medicine,Guangzhou 510405)
出处
《中国中西医结合肾病杂志》
2021年第6期490-494,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
国家中医药管理局行业专项基金资助项目(No.2015KT1016)。
关键词
狼疮性肾炎
预后
血尿酸
高尿酸血症
Lupus nephritis
Prognosis
Serum uric acid
Hyperuricemia
