525例伴血脂异常IgA肾病患者的临床病理分析  

Clinico-pathological analysis of 525 IgA nephropathy patients with dyslipidemia

作　　者：王宇 古炀晖 程小红 刘旭生[4] 邹川[4] WANG Yu;GU Yanghui;CHENG Xiaohong;LIU Xusheng;ZOU Chuan(The Second Clinical Medical College,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,China;Internal Medicine-Cardiovascular Department,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033,China;Nephropathy Department,Shaanxi Provincial Hospital of Chinese Medicine,Xi′an 710003,China;Nephropathy Department,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]深圳市中医院心内科,广东深圳518033 [3]陕西省中医医院肾病科,陕西西安710003 [4]广东省中医院肾病科,广东广州510120

出　　处：《暨南大学学报（自然科学与医学版）》2018年第2期175-184,共10页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项项目(JDZX2015202)

摘　　要：目的:探究不同血脂类型的IgA肾病患者的临床病理表现的差异.方法:采用横断面研究设计,纳入525例IgA肾病患者的性别、基线年龄、基线病程、基线血压、高血压病史、血肌酐、eGFR、尿酸、24 h小时尿蛋白定量、尿红细胞计数、血清白蛋白、血脂、Katafuchi半定量病理积分系统(包括小球积分、小管-间质积分、血管积分)等临床病理资料,根据血脂结果将患者分为血脂正常组、高胆固醇血症组、高甘油三酯血症组、低高密度脂蛋白组,分别比较各组临床病理指标的差异.结果:高甘油三酯血症组的间质纤维化积分、小管萎缩积分、小管间质积分、血管壁增厚积分、血管积分、katafuchi总积分高于血脂正常组;其小球增殖积分低于高胆固醇血症组;而血管壁增厚积分高于高胆固醇血症组.结论:不同血脂异常类型的IgA肾病患者的病理损害程度并不完全相同,其中高甘油三酯血症可能对肾脏病理改变影响较大.Objective:To explore the clinico-pathological characteristics of IgA nephropathy patients with different types of blood lipid metabolism.Methods:This cross-sectional study enrolled 525 IgA nephropathy patients,and the baseline datas of gender,age,disease course,blood pressure,history of hypertension,serum creatinine,uric acid,urinary protein excretion,urine erythrocyte,serum albumin,triglyceride,cholesterol,high-density lipoprotein,and Katafuchi semi-quantitative scoring system(including glomerular score,tubulointerstitial score,vascular score)were collected.According to the blood lipid levels,the patients were divided into normal blood lipid group,hypercholesterolemia group,hypertriglyceridemia group and low high-density lipoprotein group.The differences in clinical pathological index between the two groups was compared.Results:The Interstitial fibrosis score,tubule atrophy score,tubule interstitial score,vessel wall thickening score,vascular score and katafuchi total score in the hypertriglyceridemia group were higher than those in the normal lipid group;the glomerular proliferation score was lower than the hypercholesterolemia group,and the vessel wall thickening score in the hypertriglyceridemia group were higher than those in the hypercholesterolemia group.Conclusion:The pathological damage degree of IgA nephropathy patients with different types of dyslipidemia is not exactly the same.Hypertriglyceridemia may have a greater impact on renal pathological changes.

关 键 词：IGA肾病 血脂异常 临床病理 

分 类 号：R692.3[医药卫生—泌尿科学]