IgA肾病患者肾内小动脉硬化的影响因素分析  

Influencing factors of intrarenal arteriosclerosis in patients with IgA nephropathy

作　　者：余翔 麦麦提艾力.艾比布拉 YU Xiang;Mai mai ti ai li·Ai bi bu la(Department of Renal Diseases,the People's Hospital of Hetian,Hetian,Xinjiang 848000,China)

机构地区：[1]新疆和田地区人民医院(西院区)肾病科,新疆和田848000

出　　处：《新疆医学》2019年第3期261-264,共4页Xinjiang Medical Journal

摘　　要：目的探讨IgA肾病患者肾内小动脉硬化(RAS)的影响因素分析。方法选取2014年2月—2018年7月就诊于本院的原发性IgA肾病患者230例,按RAS数分为三组,A组108例,B组87例,C组35例。比较三组一般资料以及肾小球球性硬化、系膜增生、肾小管间质损害、炎细胞浸润的病理积分以及动脉硬化指数,并分析RAS的影响因素。结果 B组和C组高血压发生率、发病年龄、病程、尿蛋白定量、血尿酸、双侧上下肢的踝-肱指数(ABI)、臂踝脉搏波传导速度(baPWV)均高于A组,C组恶性高血压发生率高于A组,C组恶性高血压和高血压发生率、发病年龄、病程、血尿酸水平均高于B组,差异有统计学意义(P<0.05);C组肾小球球性硬化、系膜增生、肾小管间质损害、炎细胞浸润的病理积分>B组>A组,差异有统计学意义(P<0.05);Logistic回归分析显示,恶性高血压、病程、肾小管间质损害、ABI、baPWV是RAS发生的独立危险因素(P<0.05)。结论恶性高血压、病程、肾小管间质损害、动脉硬化指数是IgA肾病患者发生RAS重要影响因素,临床应加以重视,积极防治。Objective To investigate the influencing factors of intrarenal arteriosclerosis(RAS) in patients with IgA nephropathy.Methods A total of 230 patients with primary IgA nephropathy who were admitted to our hospital from February 2014 to July 2018 were enrolled.The patients were divided into three groups according to RAS number,108 in the group A,87 in the group B and 35 in the group C.Three groups of general data and pathological scores of global sclerosis,mesangial proliferation,tubulointerstitial damage,inflammatory cell infiltration were compared,and the influencing factors of RAS were analyzed.Results The incidence of hypertension,age of onset,duration of disease,BMI,urine protein quantitation,and blood uric acid were higher in the group B and the group C than that of the group A.The incidence of malignant hypertension in the group C was higher than that of the group A.The group C had malignant hypertension and hypertension.The incidence,age of onset,duration of disease,and blood uric acid level were higher than that of the group B,the difference was statistically significant(P<0.05).The pathological scores of glomerular sclerosis,mesangial hyperplasia,tubulointerstitial damage and inflammatory cell infiltration in the group C were higher than that of the group B and the group A(P<0.05).Logistic regression analysis showed that malignant hypertension,course of disease,tubulointerstitial damage,ABI and baPWV were independent risk factors for RAS(P<0.05).Conclusion Malignant hypertension,disease course and tubulointerstitial damage are important factors influencing RAS in patients with IgA nephropathy.Clinical attention should be paid to it and active prevention and treatment.

关 键 词：IGA肾病 肾内小动脉硬化 影响因素 

分 类 号：R540.4[医药卫生—心血管疾病]