IgA肾病Lee分级的危险因素分析  

Analysis of Risk Factors for Lee Classification of IgA Nephropathy

作　　者：赵洁[1] 范秋灵[1] 刘楠[1] 张丛笑[1] 姜奕[1] 王力宁[1] 

机构地区：[1]中国医科大学附属第一医院肾内科,沈阳110001

出　　处：《中国医科大学学报》2010年第7期570-571,578,共3页Journal of China Medical University

摘　　要：目的分析IgA肾病病理和临床特点以及影响IgA肾病病理分级严重程度的危险因素。方法分析278例原发性IgA肾病患者的临床指标与病理分级的相关性,多因素回归分析影响病理分级的独立影响因素。结果 IgA肾病病例数占原发性肾小球疾病的52.4%;病理分级以Ⅲ和Ⅳ级为主;年龄、CKD分期、C4、收缩压、舒张压、胆固醇、低密度脂蛋白、血尿酸、24h尿蛋白定量、尿α1微球蛋白、微量白蛋白、IgG与Lee分级呈正相关(P均<0.05);血白蛋白、血红蛋白与Lee分级呈负相关(P均<0.05)。其中高血压[exp(B)=11.308]、高低密度脂蛋白血症[exp(B)=9.23]是IgA肾病病理分级严重的独立危险因素,血红蛋白是保护性因素[exp(B)=0.183]。结论高龄、尿蛋白量大、肾功能损害、低蛋白血症、伴高血压、贫血、高脂血症、高尿酸血症的患者,IgA肾病的病理分级重的可能性大;高血压、高低密度脂蛋白血症和贫血是IgA肾病病理分级重的独立危险因素。Objective To analyze the pathological and clinical characteristics of IgA nephropathy and the risk factors affecting pathological classification of IgA nephropathy.Methods Spearman＇s rank correlation test was performed to analyze the correlation between clinical parameters and pathological classification.The independent risk factors affecting the pathological classification were analyzed by multivariate regression analysis.Results IgA nephropathy accounted for 52.4% of primary glomerulonephritis.According to Lee classification,the main pathological classifications were grades Ⅲ and Ⅳ.Age,stages of chronic kidney disease,C4,systolic blood pressure,diastolic blood pressure,cholesterol,low-density lipoprotein,serum uric acid,24-hour urine protein excretion,α1-microglobulin,and IgG level in urine were positively correlated with Lee classification（all P 0.05）,and albumin and hemoglobin were negatively correlated with it（both P 0.05）.High systolic blood pressure[exp（B）=11.308]and high level of low-density lipoprotein[exp（B）=9.23]were independent risk factors for the pathological classification of IgA nephropathy,and hemoglobin[exp（B）=0.183]was the protective factor.Conclusion The elderly patients and patients with high urine protein excretion,renal failure,hypoproteinemia,hypertension,anemia,hyperlipoidemia,and hyperuricemia tend to have higher grader of IgA nephropathy.Hypertension,high level of low-density lipoprotein,and anemia are the independent risk factors for IgA nephropathy.

关 键 词：IGA肾病 Lee分级 危险因素 

分 类 号：R692.31[医药卫生—泌尿科学]