25羟维生素D_3与IgA肾病临床病理关系研究  

The Analysis of the correlations between the levels of 25?hydroxy?vitamin D_3 and pathological and clinical characteristics of IgA nephropathy

作　　者：孙达[1] 王娇姣 王力宁[1] 刘林林[1] 王娟[1] 王蒙[1] 刘晓丹[1] 李子龙[1] 李艳秋[1] 

机构地区：[1]中国医科大学附属第一医院肾内科,辽宁沈阳110001 [2]辽宁省电力中心医院血液净化科,辽宁沈阳110006

出　　处：《中国实用内科杂志》2016年第6期472-475,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(81370870)

摘　　要：目的探讨25羟维生素D_3[25(OH)D_3]与Ig A肾病患者临床指标及病理改变的关系。方法回顾性分析2014年12月至2015年12月中国医科大学附属第一医院肾内科264例经肾活检证实为原发性IgA肾病患者的病理及临床资料,分析不同维生素D水平对IgA肾病病理和临床指标的影响。结果 (1)随25(OH)D_3水平的下降,血肌酐(Cr)、尿素氮(BUN)、血清胱抑素C(Cys-C)及24 h尿蛋白定量水平随之升高,差异具有统计学意义(P<0.05)。(2)随25(OH)D_3水平下降,球性硬化、节段性硬化及新月体病变的数量增多。25(OH)D_3水平也与毛细血管内增生(E),肾小管萎缩和(或)间质纤维化(T)、球性硬化(Y)、新月体病变(C)程度相关(P<0.05)。结论 25(OH)D_3水平与IgA肾病临床及病理严重程度密切相关,可能是影响IgA肾病预后的重要因素。Objective To investigate the relationship between the levels of 25-hydroxy-vitamin D3 and the clinical and pathological characteristics of IgA nephropathy. Methods We analyzed retrospectively the clinical and pathological data of 264 patients with primary IgA nephropathy diagnosed by renal biopsy in the Department of Nephrology of the First Affaliated Hospital of China Medical Universi~, and explored the effects of different levels of 25-hydroxy-vitamin D3 on pathological and clinical data. Results （1） With the decrease of 25-hydroxy-vitamin D3 concentration, the levels of serum Cr, BUN, Cys-c and 24 hour urinary protein content increased, the differences among the groups were all statistical significant （P〈0.05）. （2） With the decrease of 25-hydroxy-vitamin D3 levels, the numbers of global sclerotic glomeruli, segmental sclerosis glomeruli and crescent increased. 25-hydroxy-vitamin D3 levels were also correlated with endocapillary hyperceUularity （E）, renal tubular atrophy/interstitial fibrosis （T）, global sclerosis （y） and crescents （C） changes were correlated （P〈0.05）. Conclusion The levels of 25-hydroxy-vitamin D3 were closely associated with the clinical and pathological parameters ofIgA nephropathy, which may be an important factor to affect the prognosis oflgA nephropathy.

关 键 词：IGA肾病 25羟维生素D3 肾脏病理 

分 类 号：R692[医药卫生—泌尿科学]