摘要
目的 分析探讨IgA肾病患者血脂指标与其临床特征及肾脏病理特征的关系。方法 选取150例IgA肾病患者,根据血脂水平分为血脂正常组和血脂异常组;根据血脂异常的类型,将血脂异常组进一步分为高胆固醇血症组、高甘油三脂血症组、混合性高脂血症组及低高密度脂蛋白血症组。分析比较各组的临床特征及肾脏病理特征。结果 血脂异常组体质指数(BMI)、尿素氮(BUN)、血肌酐(SCr)、血尿酸(UA)、24 h尿蛋白定量(24h-UP)高于血脂正常组(P <0.05),白蛋白(Alb)、肾小球滤过率(eGFR)低于血脂正常组(P <0.05)。不同类型血脂异常各组间,高甘油三酯血症组UA高于其他血脂异常组(P <0.05),混合性高脂血症组Alb低于其他血脂异常组(P <0.05),24h-UP高于其他血脂异常组(P <0.05)。病理分级中Lee分级为Ⅲ级至Ⅴ级在血脂异常组中的占比较血脂正常组高(P <0.05),MEST-C评分中血脂异常组中T1、T2占比相较血脂正常组多(P <0.05)。多因素Logistic回归分析结果显示,BMI是IgAN患者伴发血脂异常的高危因素。结论 血脂异常对IgAN肾功能进展具有一定预测作用。血脂异常组具有更严重的肾脏病理分级,在肾小管萎缩/肾间质纤维化方面表现更为显著。BMI升高是IgAN患者伴发血脂异常的高危因素。
Objective To investigate the relationship between dyslipidemia and its clinical features and renal pathological features in patients with IgA nephropathy.Methods 150 patients with lgA nephropathy were divided into dyslipidemia group and normal blood lipid group,according to the blood lipid level.The dyslipidemia group was further divided into hypercholesterolemia group,hypertriglyceridemia group,mixed hyperlipidemia group and low high density lipoproteinemia group according to the types of dyslipidemia.The clinical features and pathological characteristics of each group.Results Compared with normal blood lipid group,BMI,urea,creatinine,uric acid and 24h-UP of abnormal blood lipid group were significantly higher(P < 0.05),albumin,eGFR in dyslipidemia group were lower(P < 0.05).Between different types of dyslipidemia,serum uric acid in hypertriglyceridemia group was higher than that in other dyslipidemia groups(P < 0.05).The serum albumin in mixed hyperlipidemia group was lower than that in other dyslipidemia groups(P < 0.05),while the 24-hour urine protein content was higher than that in other dyslipidemia groups(P < 0.05).The proportion of Lee’s pathological grade Ⅲ-Ⅴ in dyslipidemia group was higher than that in normal blood lipid group,and the difference was statistically significant(P < 0.05).The proportion of T1 and T2 in dyslipidemia group was higher than that in the normal blood lipid group( P < 0.05).Multivariatelogistic regression analysis showed that BMI was a high-risk factor for dyslipidemia in patients with IgA nephropathy.Conclusions Dyslipidemia can predict the disease and progression of IgAN.The dyslipidemia group has more severe renal clinical features and pathological grading,and is more pronounced in tubular atrophy/interstitial fibrosis.Elevated BMI is a highrisk factor for dyslipidemia in IgAN patients.
作者
陈靖珊
李黎
赏石丽
何国勇
周文京
李莎
张迪
刘勇兰
李俊
CHEN Jingshan;LI Li;SHANG Shili;HE Guoyong;ZHOU Wenjing;LI Sha;ZHANG Di;LIU Yonglan;LI Jun(Dept.of Nephrology,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032;Dept.of Nephrology,The 1st People’s Hospital of Kunming,Kunming Yunnan 650200,China)
出处
《昆明医科大学学报》
CAS
2023年第1期47-53,共7页
Journal of Kunming Medical University
基金
云南省高层次人才培养支持计划基金资助项目(RLMY20200022)
云南省教育厅科学研究基金资助项目(2022J0269)
昆明医科大学研究生创新基金资助项目(2022S222)
国家级教学质量工程基金资助项目(2022JXD209)。
关键词
IGA肾病
血脂异常
病理
临床特征
危险因素
IgA nephropathy
Dyslipidemia
Pathological
Clinical features
Risk factors
