IgA肾病进展的危险因素研究  

The Analysis of the risk factors on IgA nephropathy progression

作　　者：李博[1,2] 保莉[1,2] 张国庆[1,2] 王慧[1,2] 张艳[2] 杨丽嵘[1,2] 郑亚莉[1,2] LI Bo BAO Li ZHANG Guoqing WANG Hhui ZHANG Yah YANG Lirong ZHENG Yali(Department of Nephrology, Ningxia People＇ s Hospital, Yinchuan 750002, China The First Clinical Medical College of Northwest University for Nationalities, Yinchuan 750002, China)

机构地区：[1]宁夏人民医院肾脏内科,宁夏银川750002 [2]西北民族大学第一临床医学院,宁夏银川750002

出　　处：《宁夏医学杂志》2017年第3期229-232,共4页Ningxia Medical Journal

基　　金：宁夏自然科学基金资助项目(NZ15191);宁夏重点研发计划科技惠民项目(2016KJHM84);宁夏重点研发计划科技惠民项目(2016KJHM87)

摘　　要：目的研究IgA肾病(IgAN)的临床及病理特点,分析与其病情进展的相关因素。方法回顾性研究经肾活检病理诊断为IgA肾病并长期随访患者113例的资料,以1年内血肌酐是否升高到基础值的50%分为2组,对肾活检时各临床及实验室病理指标进行单因素分析,单因素分析差异有统计学意义的进行多因素分析,得出IgAN进展的危险因素。结果影响IgAN患者肾功能进展的指标中,发病时的年龄、血红蛋白、血尿程度、24 h尿蛋白定量、高血压、肌酐、尿酸、同型半胱氨酸、牛津分型及新月体比例,2组患者比较差异有统计学意义(P<0.05)。多因素分析提示,年龄(OR=1.071)、24尿蛋白定量(OR=3.624)、高血压(OR=5.618)、肌酐(OR=3.007)、尿酸(OR=1.008)、同型半胱氨酸(OR=1.056)为IgAN肾功能恶化的危险因素。结论研究提示IgAN进展的危险因素为发病时的年龄、血肌酐、尿酸、蛋白尿水平、高血压及血同型半胱氨酸水平,临床上可以对以上因素进行早期干预,以延缓IgAN的进展。Objective To analyze the risk factors of IgA nephropathy and the clinical and pathological characteristics of IgA ne- phropathy （IgAN） and to study the factors related to the progression of IgA nephropathy. Methods A retrospective study, 113 patients were conducted with primary IgA nephropathy and followed - up. The patients were divided into two groups according to whether the serum creati- nine increased to 50% of the baseline value within one year. The clinical,laboratory,and pathological indexes in two groups were analyzed by univariate analysis and single factor analysis. The risk factors which affect IgA nephropathy progression were obtained by multivariate a- nalysis. Results There were statistically significant differences between two groups in following indexes ： age （ P 〈 0. 05 ）, hemoglobin （ P 〈 0.05 ）, degree of hematuria （ P 〈 0.05 ） and 24 - urinary protein （ P 〈 0.05 ） in IgA nephropathy （ P 〈 0.05 ）, uric acid （ P 〈 0.05 ）, homocysteine （P 〈 0.05 ）, Oxford classification （ P 〈 0.05 ） and crescents （ P 〈 0.05 ）. Multivariate analysis showed that age （ OR = 1.071 ）, urinary protein （ OR = 3. 624）, hypertension （ OR = 5.618）, creatinine （ OR = 3. 007）, uric acid （ OR = 1. 008 ）, and homocysteine （ OR = 1. 056） were risk factors for renal function deterioration in IgA nephropathy. Conclusion The risk factors for progression of IgA ne- phropathy are age of onset,the level of serum creatinine,and uric acid,the progression of IgA nephropathy.

关 键 词：IG AN 危险因素 牛津分型 

分 类 号：R692.31[医药卫生—泌尿科学]