肾小球疾病患者临床和肾脏病理学因素对高尿酸血症患病率的影响  

Relationship between the incidence of hyperuricemia and the clinical and pathological features in patientswith renal glomerular disease

作　　者：郑丽环[1] 傅淑霞[1] 张春霞[1] 李绍梅[1] 张丽萍[1] 段建召[1] 裴华颖[1] 

机构地区：[1]河北医科大学第二医院肾内科,石家庄050000

出　　处：《中国综合临床》2013年第1期65-68,共4页Clinical Medicine of China

摘　　要：目的探讨肾小球疾病患者临床和病理学因素对高尿酸血症（HUA）患病率的影响。方法回顾性分析2007年1月至2011年12月间，经肾脏活检确诊的3547例肾小球疾病患者的临床和病理学资料，并进行统计学分析。结果（1）在所有肾小球疾病患者中，HUA患病率为21．8％（773／3547），其中继发性肾小球疾病27．2％（240／882）高于原发性的20．7％（552／2665），差异有统计学意义（X^2=153．642，P〈0．05）；原发性肾小球疾病中膜性肾病HUA的患病率最低，为14．4％（96／665）；继发性肾小球疾病中狼疮性肾炎HUA的患病率最高，为45．3％（110／243），小血管炎肾损害[34．7％（17／49）]次之。（2）随着肾小球硬化指数、肾小管间质积分、肾内血管病变积分和慢性肾脏病分期的增加，HUA患病率进行性增加（X^2值为17．798-298．216，P均=0．000）。（3）二项Logistic回归分析提示：肾小管间质积分和肾小球硬化指数高、肾功能减退、男性、超重或肥胖、高血压和高甘油三酯均是HUA的危险因素（OR为1．011-7．513，P均〈0．05）。结论近1／4的。肾小球疾病患者血尿酸升高；肾小管间质病变重、肾小球硬化指数高、。肾小球滤过功能差、男性、超重或肥胖、高血压和高甘油三酯均是HUA的独立危险因素。Objective To explore the effect of clinical and pathological features on the incidence of Hyperuricemia （HUA） in renal glomerular disease. Methods A retrospective analysis was applied to review the clinical and pathologieal date collected from 3547 patients with renal glomerular disease. These patients were diagnosed as renal glomerular disease by renal biopsy from January 2007 to December 2011. Results （ 1 ） HUA incidence was 21.8% （773/3547） in all of the patients,in which the incidence in secondary glomerular disease 27.2% （240/882） was much higher than that in primary glomerular disease 20.7% （552/2665）, and the difference was significant （ X^2 = 153. 642, P 〈 0.05 ）. In primary glomerular disease, HUA incidence was the lowest in membranous nephropathy 14.4% （96/665）, while HUA incidence in lupus nephritis （LN） 45.3% （ 110/243 ） was the highest and small blood vessel infammation kidney damage 34. 7% （17/49） was the second in secondary glomerular disease. （ 2 ） With the increasing of glomeruloselerosis index, tubulointerstitial score, renal vascular lesions score and the stage of chronic kidney disease, HUA incidence increased （ X^2 = 17. 798 - 298. 216,P = 0. 000）. （3）Logistic regression analysis showed that high tubulointerstitial score,glomerul- oselerosis index and renal dysfunction, male, overweight or obese, hypertension and hypertriglyceridemia were risk factors for hyperuricernia （ OR： 1. 011 - 7.513, P 〈 0. 05 ）. Conclusion The uric acid level is increased in nearly a quarter of patients with renal glomerular disease. Severe tubulointerstitial lesion, high gjomerulosclerosis index, low glomerular filtration rate, male, overweight or obese, hypertension and hypertriglyceridemia were independent risk factors for HUA.

关 键 词：肾小球疾病 慢性.肾脏病 高尿酸血症 患病率 

分 类 号：R692[医药卫生—泌尿科学] R589[医药卫生—外科学]