IgA肾病合并高尿酸血症的临床分析  

Clinical Manifestations and Pathological Characteristics of IgA Nephropathy with Hyperuricemia

作　　者：邢瑞青[1] 王菁[1] 杨玉琪[1] 张小宁[1] 程晓东[1] 彭道荣[1] 

机构地区：[1]第四军医大学西京医院临床实验研究所,陕西西安710032

出　　处：《现代生物医学进展》2013年第22期4272-4274,4291,共4页Progress in Modern Biomedicine

摘　　要：目的：探讨血清尿酸对IgA肾病临床,病理及预后的影响,为临床治疗和预后评估提供依据。方法：分析我院2011年1月-2012年1月149例经肾穿活检确诊为原发性IgA肾病患者的临床和病理资料。采用t检验和X2检验进行统计学处理。结果：（1）伴高尿酸血症IgA肾病的发病率为30.2%,男性偏多,男女发病率无统计学差异（P〉0.05）。（2）女性高尿酸血症组BUN、Cys-C、Scr水平显著高于尿酸正常组（P〈0.05）,男性两组间无显著差异（P〉0.05）,而血清UA水平无论男女高尿酸血症组均显著高于尿酸正常组（P〈0.05）;尿酸正常组血清BUN、UA、Cys-C、Scr水平男性显著高于女性（P〈0.05）,高尿酸血症组血清UA水平男性显著高于女性（P〈0.05）;血清IgA、C3、IgA/C3比值无论男女,高尿酸血症组与尿酸正常组均无显著差异（P〉0.05）。（3）高尿酸血症组病理改变以Ⅳ-Ⅴ多见（57.8%）,而正常尿酸组则以Ⅰ-Ⅱ为主（46.2%）,血尿酸正常组与高尿酸血症组Lee＇s分级构成比差异具有统计学意义（P〈0.05）。结论：伴有高尿酸血症的IgA肾病患者男性血尿酸水平高于女性,但血尿酸水平升高对女性肾功能影响更大;高尿酸血症对血清IgA,C3水平的变化影响不大;伴高尿酸血症IgA肾病病理改变程度较尿酸正常组更加严重。Objective： To explore the effect of serum of UA on the clinical manifestations,pathological characteristics and prognosis of IgA nephropathy,in order to provide valid evidence for the clinical treatment and assessment.Methods： 149 cases of primary IgA nephropathy confirmed by renal biopsy from Jan 2011 to Jan 2012 in Xijing Hospital were reviewed.The clinical manifestations and pathological characteristics of all the patients were analyzed.χ2-test and t-test were used for statistical analysis.Results：（1）The incidence of hyperuricemia in IgA nephropathy was 30.2%,but there was no statistical significance between male and female.（2）The contents of BUN,Cys-C,Scr in female cases were significantly higher in hyperuricemia group than that in normal serum UA group（P0.05）while there was no significant differences between two groups in male cases（P0.05）.The contents of UA were significantly higher in hyperuricemia group than that in normal serum UA group in either male or female cases（P0.05）.The contents of BUN,UA,Cys-C,Scr in normal serum UA group were significantly higher in mail than that in female cases（P0.05）,meanwhile,the contents of UA in hyperuricemia group were also significantly higher in male than that in female cases（P0.05）.The contents of IgA,C3,IgA/C3 were not significantly different between hyperuricemia group and normal serum UA group in either male or female cases（P0.05）.（3）There was statistical significance between hyperuricemia group and normal serum UA group in the constituent ratio of Lee＇s grade（P0.05）,while Lee＇s gradeⅣ-Ⅴchanges were predominant in hyperuricemia group（57.8%） and Lee＇s grade Ⅰ-Ⅱ changes were predominant in normal serum UA group（46.2%）.Conclusion： Compared with the female cases,the contents of UA in the IgA nephropathy with hyperuricemia patients were higher in male cases,but there were more influences of higher serum UA to the renal function in female than that in male.The level of serum UA might not influent to t

关 键 词：高尿酸血症 IGA肾病 临床病理特征 

分 类 号：R692.31[医药卫生—泌尿科学]