摘要
目的通过收集、总结、分析IgA肾病患者的临床资料,探究扁桃体切除术对IgA肾病患者预后的影响。方法选取2012-01-01至2015-12-31在中国医科大学附属第一医院肾内科住院初次确诊为IgA肾病合并慢性扁桃体炎的患者83例。回顾性分析患者的临床资料。结果83例患者中,接受扁桃体切除术的患者34例,平均随访时间(46.9±13.7)个月。多因素COX分析:当eGFR<50 mL/(min·1.73 m^(2))或24 h尿蛋白定量>3.0 g时,提示患者预后不良(P<0.05);肾活检病理出现内皮细胞增生,则提示患者的预后可能较好(P<0.05)。接受扁桃体切除术以及未应用激素的治疗的IgA肾病患者的预后则可能更好,差异均具有统计学意义(P<0.05)。Kaplan-Meier生存分析:随着随访时间的延长,接受扁桃体切除术的IgA肾病患者的生存时间较未接受扁桃体IgA肾病切除的患者明显延长,差异具有统计学意义(P<0.05)。结论血肌酐以及24 h尿蛋白定量水平升高提示患者预后不良,肾脏病理出现内皮细胞增生提示患者的预后可能更好。接受扁桃体切除术治疗的患者的预后可能更好,接受激素治疗的患者预后可能不良,接受扁桃体切除术治疗患者的生存时间更长。
Objective Through collecting,summarizing and analyzing the clinical data of patients with IgA nephropathy,to explore the effect of tonsillectomy on the prognosis of patients with IgA nephropathy.Method From January 1,2012 to December 31,2015,83 patients who were hospitalized in the First Hospital of China Medical University and were initially diagnosed with IgA nephropathy combined with chronic tonsillitis were selected.The clinical data of the patients were retrospectively analyzed.Result Among the 83 patients,34 patients underwent tonsillectomy,and the mean follow-up time was 46.9±13.7 months.Multivariate COX analysis:When eGFR was<50mL/(min·1.73m^(2))or 24-hour urine protein>3.0 g,the prognosis of the patient was poor(P<0.05);endothelial cell hyperplasia in renal biopsy pathology indicatet that the prognosis of the patients was probably good(P<0.05).The prognosis of patients with IgA nephropathy who received tonsillectomy and hormone-free therapy might be eren better(P<0.05).The differences were all statistically significant.Kaplan-Meier survival analysis:With the extension of follow-up time,the survival time of IgA nephropathy patients who received tonsillectomy was significantly longer than the others.The difference was statistically significant(P<0.05).Conclusion The increase of serum creatinine and 24-hour urine protein indicates that the prognosis of the patient is poor,and the renal pathology of endothelial cell hyperplasia indicates that the prognosis of the patient may be better.Patients treated with tonsillectomy may have a better prognosis,while those treated with hormone therapy may have a poor prognosis.Patients who received tonsillectomy hare a longer survival time.
作者
田滨瑶
周俊蕾
李悦
徐天华
姚丽
TIAN Bin-yao;ZHOU Jun-lei;LI Yue;XU Tian-hua;YAO Li(Department of Nephrology,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2022年第8期655-659,共5页
Chinese Journal of Practical Internal Medicine
基金
国家自然科学基金(82070763)
辽宁省重点研发指导计划(2020JH2/1030045)。
