银屑病与肾脏疾病的相关性研究  

The study of nephropathy in patients with psoriasis

作　　者：侯麦花[1] 卢新政[2] 

机构地区：[1]南京医科大学第一附属医院皮肤性病科,江苏南京210029 [2]南京医科大学第一附属医院心脏科,江苏南京210029

出　　处：《临床皮肤科杂志》2014年第7期406-408,共3页Journal of Clinical Dermatology

基　　金：江苏省六大人才高峰资助项目(2013-WSN-031)

摘　　要：目的:研究银屑病患者肾脏功能的变化情况。方法:53例银屑病患者,其中男38例,女15例,平均年龄(46±12)岁,以年龄和性别相匹配的健康者53例个体为对照组。用银屑病皮损面积和严重程度指数(PASI)评估银屑病的严重程度。所有患者及对照组均行尿液分析包括尿常规及尿沉渣镜检、24 h尿蛋白定量及尿微量白蛋白。其中尿微量白蛋白>30mg/L认为病理性白蛋白尿,对尿液检查异常的银屑病患者进行肾活检。结果:①银屑病患者和对照组的尿常规分析及镜检差异均无统计学意义(P>0.05);两组间的平均24 h蛋白尿、尿微量白蛋白差异均无统计学意义(P>0.05);但与对照组相比,银屑病患者病理性白蛋白尿的发生率显著增加(分别为24%和2%,P<0.01)。②银屑病患者的PASI分数与24 h白蛋白尿显著相关(r=0.458,P<0.01)。其中9例银屑病患者有肾功能异常,4例进行了肾活检,证实2例为肾小球肾炎,且均为系膜增殖性肾小球肾炎。结论:银屑病患者中肾脏异常并不常见,而病理性白蛋白尿发生率显著增加,且与银屑病的严重程度相关,提示银屑病患者可能存在早期肾功能损害。Objective： To evaluated the prevalence of renal abnormalities in patients with psoriasis. Methods： Fifty-three psoriasis patients [38 men, 15 women, mean age was （46±12） years old] and 53 age -gender matched control subjects without hypertension or diabetes were enrolled in the study. Psoriasis area and severity index （PASI） was used to assess the severity of psoriasis. Routine urine test, microscopic evaluation, 24 hours proteinuria and albuminuria were measured in all patients and controls. Pathologic albuminuria was difined as albumin excretion of more than 30 mg/L. Renal biopsy was performed in psoriasis patients with urinary abnormalities. Results： Patients with psoriasis and controls were not significantly different with respect to the prevalence of abnormal urinalysis （P〉0.05）, mean 24 hours proteinuria （P〉0.05） and albuminuria （P〉0.05）. However, patients with psoriasis had an increased prevalence of pathologic albuminuria compared with controls （24% vs 2%, P〈0.005）. PASI scores in psoriasis patients correlated significantly with albuminuria （r=OA58, P〈0.01）. Nine patients with psoriaisis had urinary abnormalities, four underwent renal biopsy. Two of them had biopsy-proven mesangial proliferative glomerulonephritis. Conclusion： The presence of abnormal urinalysis isn＇t common pathologic albnminuria and its positive correlation with psoriasis patients.

关 键 词：尿微量白蛋白 银屑病 肾功能 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]