湿热体质与IgA肾病临床病理及预后的关系  

Relationship Between Damp-heat Constitution and Clinical,Pathological and Prognosis of Ig A Nephropathy

作　　者：刘童童 冒慧敏[1] 李深[1] 杨丽平[1] 王倩[2] 姚瑶[3] 陈静[3] 王宇阳[1] 占永立[1] LIU Tongtong;MAO Huimin;LI Shen(Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing(100053))

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]北京中医药大学,北京100029 [3]中国中医科学院广安门医院南区,北京102618

出　　处：《中国中西医结合肾病杂志》2020年第7期593-596,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：中国中医科学院优秀青年科技人才(创新类)项目(No.ZZ13-YQ-031)。

摘　　要：目的:探讨湿热体质对Ig A肾病临床病理及预后的影响。方法:回顾性分析2003年01月~2018年12月于广安门医院肾病科住院并经肾穿刺活检诊断为Ig A肾病患者的临床及病理资料,按照湿热体质判定标准将患者分为:湿热组和非湿热组,比较两组患者的临床病理特点,以及湿热体质对Ig A肾病患者预后的影响。结果:共纳入469例Ig A肾病患者(湿热组196例,非湿热组273例),湿热组患者肾脏病理发生肾小球节段硬化或黏连的比例高于非湿热组(P <0.05);Spearman秩相关分析结果显示,湿热评分与24 h尿蛋白定量成正相关,与e GFR呈负相关;Kaplan-Meier生存分析提示湿热组的累计生存率低于非湿热组,但差异无统计学意义。单因素COX比例风险回归模型提示,湿热体质是Ig A肾病患者发生终点事件的危险因素,经多因素COX比例风险回归模型校正,湿热体质对Ig A发生终点事件的影响无统计学意义。结论:湿热体质的Ig A肾病患者有明显的临床特点,湿热体质对Ig A肾病肾脏存活有一定影响,但并没有成为影响肾脏的独立危险因素。Objective: To explore the influence of damp heat constitution on the clinical,pathological and prognosis of Ig A nephropathy. Methods: The clinical and pathological data of Ig A nephropathy patients who were diagnosed by renal biopsy in the nephrology department of Guang’anmen Hospital from January 2003 to December 2018 were analyzed retrospectively. According to the criteria of damp heat constitution,the patients were divided into two groups: Damp heat group and non damp heat group. The clinical and pathological characteristics of the two groups were compared,and the influence of damp heat constitution on the prognosis of Ig A nephropathy patients was analyzed. Results: A total of 469 Ig A nephropathy patients(196 in the damp heat group and 273 in the control group) were included. The proportion of segmental glomerulosclerosis in the damp-heat group was higher than that in the control group(P < 0. 05);Spearman rank correlation analysis showed that the wet-heat score was positively correlated with 24 hour urinary protein and negatively correlated with e GFR;Kaplan-Meier survival analysis showed that the cumulative survival rate of damp-heat constitution was lower than that of non-damp-heat constitution,but there was no statistical difference;Univariate COX proportional risk regression model suggests that damp-heat constitution is a risk factor for the occurrence of end-point events in Ig A nephropathy patients. Corrected by multivariate COX proportional risk regression model,the effect of damp-heat constitution on the occurrence of end-point events of Ig A has no statistical significance. Conclusion: Ig A nephropathy patients with damp heat constitution have obvious clinical characteristics,and damp heat constitution has certain influence on the survival of Ig A nephropathy patients,but it does not become an independent risk factor of kidney.

关 键 词：湿热体质 IGA肾病 临床特点 病理特点 预后 

分 类 号：R277.5[医药卫生—中医学]