成人原发性IgA肾病与血免疫球蛋白及补体的相关关系  

Relationship of adult and primary IgA nephropathy with serum levels of immunoglobulins and complement

作　　者：王文涛[1] 黄婷 何堤[2] 范媛敏 张亚莉[1] 冯学亮[1] WANG Wentao;HUANG Ting;HE Di;FANG Yuanming;ZHANG Yali;FENG Xueliang(Department of Nephrology,First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710061,China;Department of Nephrology,Central Hospital of Hanzhong City;Department of Nephrology,Tongchuan Mining Bureau Center Hospital)

机构地区：[1]西安交通大学第一附属医院肾内科,西安710061 [2]汉中市中心医院肾内科 [3]铜川矿务局中心医院肾内科

出　　处：《山西医科大学学报》2018年第8期963-967,共5页Journal of Shanxi Medical University

基　　金：陕西省科技惠民专项基金(2013K14-02-14)

摘　　要：目的观察IgA肾病患者血清学的免疫球蛋白及补体的变化,以探索成人IgA肾病患者的血清免疫球蛋白及补体的规律并指导临床。方法回顾分析2005-01~2014-12在我院住院经肾活检病理检查且资料较完整的1234例诊断为成人IgA肾病患者的临床表现与血清免疫球蛋白及补体的相关关系。结果(1)IgA肾病患者病程的长短与血清IgG浓度呈正相关,与IgA浓度呈负相关(P<0.05)。(2)有水肿患者血清IgG、IgA低于无水肿的患者,而血清C4高于无水肿的患者。有血尿的患者血清C3较无血尿的高。血压与血清IgM呈负相关,差异均有统计学意义(P<0.05)。(3)尿蛋白与血清IgG、IgA、IgM均呈负相关,与C4成正相关;血浆白蛋白与血清IgG、IgA、C3呈正相关;胆固醇与血清IgG、IgA呈负相关,与C3、C4呈正相关;血尿素氮与血清IgG、IgA、IgM、C3呈负相关;血肌酐与血清IgM、C3呈负相关,与C4呈正相关,差异均有统计学意义(P<0.05)。(4)疾病危险度与血清IgG、IgM、C3呈负相关,病理分级与血清IgM呈负相关(P<0.05)。(5)肾脏中IgA沉积强度与血清C4呈负相关;肾脏中IgM沉积强度与血清IgG呈负相关,与血清IgM呈正相关;肾脏中C3沉积强度与血清C4呈负相关(P<0.05)。结论(1)IgA肾病患者普遍存在血清免疫学的异常。(2)IgA肾病患者血清IgG、IgA的变化较常见,有水肿患者其浓度较低,且其变化与尿蛋白、血浆白蛋白、胆固醇、疾病危险度相关(疾病危险度中IgA的除外)。(3)IgA肾病患者血清IgM、补体C3、C4的变化规律性不明确。Objective To observe changes of serum immunoglobulins and complement in patients with primary IgA nephropathy（IgAN）,and explore its regular changes and clinical significance.Methods A total of 1 234 patients diagnosed with adult IgA nephropathy by renal biopsy and with intact documents in our hospital from January 2005 to December 2014 were enrolled in this study.The clinical data were retrospectively analyzed,and the correlations between the clinical manifestations of these IgA nephropathy patients and serum immunoglobulin and complement were analyzed.Results（1）The course of disease of patients with IgA nephropathy was positively correlated with the serum level of Ig G,but negatively correlated with the serum level of IgA（P〈 0.05）.（2）The serum levels of IgA and Ig G in edema were lower than those in non-edema IgAN,while serum level of C4 in edema was higher than that of nonedema patients（P〈 0.05）.The serum level of C3 in patients with hematuria was higher than that of non-hematuria（P 〈0.05）.The pressure of blood was negatively correlated with the serum level of Ig M（P 〈0.05）.（3）Urinary protein was negatively correlated with the serum level of Ig G,IgA,Ig M（P 〈0.05）,but positively correlated with the serum level of C4（P〈 0.05）.Plasma albumin was positively correlated with serum levels of Ig G,IgA and C3（P 0.05）.Cholesterol was negatively correlated with serum levels of IgA and Ig G（P〈 0.05）,but positively with serum levels of C3 and C4（P 〈0.05）.Blood urea nitrogen was negatively correlated with serum levels of Ig G,IgA,Ig M and C3（P 〈0.05）.Creatinine was negatively correlated with serum levels of Ig M and C3（P 0.05）,but positively correlated with the serum level of C4（P 〈0.05）.（4）The severity of the disease was negatively correlated with serum levels of Ig G,Ig M and C3,and the pathological grades of IgAN was negatively correlated with the serum level of Ig M（P 〈0.05）.（5）The deposition intensity of IgAN was negativel

关 键 词：IGA肾病 免疫球蛋白 补体 成人 

分 类 号：R692[医药卫生—泌尿科学]