lgA肾病牛津病理分型特点及对疾病预后影响分析  

Pathological Classification of lgA Nephropathy in Oxford and Its Impact on Disease Prognosis

作　　者：涂宁芳 袁雅玲 龚龙 TU Ningfang;YUAN Yaling;GONG Long(Department of Pathology,First People’s Hospital of Xiaogan,Xiaogan Hubei 432100,China)

机构地区：[1]孝感市第一人民医院病理科,湖北孝感432100

出　　处：《中国继续医学教育》2019年第2期63-66,共4页China Continuing Medical Education

摘　　要：目的探讨lgA肾病患者的牛津病理分型特点及对疾病预后的影响。方法收集2012年1—12月原发性lgA肾病患者200例,对其临床特征和牛津病理分型进行分析,并探讨牛津病理分型对疾病预后的影响。结果 M0和M1两组患者在血尿酸、尿蛋白和e GFR上差异具有统计学意义(P <0.05)。S0和S1两组患者在血肌酐上差异具有统计学意义(P <0.05)。T0、T1和T2在尿素氮、血肌酐、血尿酸、尿蛋白和e GFR上差异具有统计学意义(P <0.05)。在预后分析中,校正混杂因素后,系膜增生和小管萎缩/间质纤维化是影响lgA肾病患者预后的独立影响因素(P <0.05),M1患者发生不良疾病预后的风险度是M0患者的1.712倍(χ~2=7.556,P <0.001),T1患者发生不良疾病预后的风险度是T0患者的1.341倍(χ~2=4.507,P <0.05),T2患者发生不良疾病预后的风险度是T0患者的2.012倍(χ~2=11.893,P <0.001)。结论 lgA肾病患者临床病理表现具有一定特征,其牛津病理分型与疾病预后以及肾功能变化具有密切相关。Objective To investigate the pathological characteristics and prognosis of lgA nephropathy in Oxford.Methods 200 cases with primary lgA nephropathy from January to December 2012 were collected as the research objectives.The clinical features and Oxford pathological classification were analyzed,and the influence of Oxford pathological classification on the prognosis of the disease was explored.Results There were significant differences in serum uric acid,urinary protein and eGFR between M0 and M1 groups(P<0.05).The difference of serum creatinine between the two groups of S0 and S1 was statistically significant(P<0.05).T0,T1 and T2 were significantly different in urea nitrogen,serum creatinine,serum uric acid,urinary protein and eGFR(P<0.05).In prognostic analysis,after adjusting for confounding factors,mesangial hyperplasia and tubular atrophy/interstitial fibrosis were independent prognostic factors in patients with lgA nephropathy P<0.05).The risk of adverse disease prognosis in M1 patients was 1.712 times that in M0 patients(χ^2=7.556,P<0.001),the risk of poor prognosis in T1 patients was 1.341 times higher than that in T0 patients(χ^2=4.507,P<0.05).The risk of adverse prognosis in patients with T2 was 2.012 times higher than that in patients with T0(χ^2=11.893,P<0.001).Conclusion lgA nephropathy has certain clinical and pathological characteristics,and its Oxford pathological classification is closely related to the prognosis of the disease and the changes of renal function.

关 键 词：LGA肾病 病理 牛津分型 预后 临床特征 肾功能 

分 类 号：R692[医药卫生—泌尿科学]