过敏性紫癜性肾炎临床预后影响因素研究  

Study on influencing factors of clinical prognosis of Henoch-Schonlein purpura nephritis

作　　者：王小艳 杨俊武 张蓬杰[3] WANG Xiaoyan;YANG Junwu;ZHANG Pengjie(Department of Nephrology,Pucheng County Hospital,Weinan 715500,Shaanxi,China;Department of Hepatobiliary,Pucheng County Hospital,Weinan 715500,Shaanxi,China;Kidney Disease Center of Shaanxi Provincial People's Hospital,Xi'an 710068,Shaanxi,China)

机构地区：[1]陕西省渭南市蒲城县医院肾病科,陕西渭南715500 [2]陕西省渭南市蒲城县医院肝胆科,陕西渭南715500 [3]陕西省人民医院肾病中心,陕西西安710068

出　　处：《右江医学》2022年第1期58-61,共4页Chinese Youjiang Medical Journal

摘　　要：目的探讨过敏性紫癜性肾炎临床预后影响因素。方法研究纳入陕西省人民医院2010年1月~2016年5月收治的过敏性紫癜性肾炎患者共138例,根据肾组织活检结果分组,其中无新月体组50例,节段性新月体组18例,大新月体组70例;比较不同病理类型的肾脏功能良好率,多因素Cox回归模型分析过敏性紫癜性肾炎临床预后独立危险因素。结果各组不同组间年龄、24 h尿蛋白量、Scr、eGFR、新月体类型、合并内皮增生比例及系膜增生比例比较差异有统计学意义(P<0.05);各组随访肾脏功能良好率比较差异有统计学意义,且大新月体组随访肾脏功能良好率显著低于其他两组(均P<0.01);多因素Cox回归模型分析结果显示,基线eGFR水平、合并大新月体比例可能是过敏性紫癜性肾炎临床预后的独立影响因素(P<0.05)。结论过敏性紫癜性肾炎各病理类型之间临床特征存在明显差异,其临床预后可能受患者基线eGFR水平、合并大新月体比例影响。Objective To investigate the influencing factors of clinical prognosis of Henoch-Schonlein purpura nephritis. Methods 138 patients with Henoch-Schonlein purpura nephritis admitted to Shaanxi Provincial People’s Hospital from January 2010 to May 2016 were enrolled in this study. All patients were grouped according to the results of renal biopsy, there were 50 cases in non crescentic group, 18 cases in segmental crescentic group and 70 cases in large crescentic group. The good rate of renal function of different pathological types was compared, and multivariate Cox regression model was used to analyze the independent risk factors of clinical prognosis of Henoch-Schonlein purpura nephritis. Results There were statistically significant differences in sex, 24-hour urine protein, Scr, eGFR, the proportion of complicated endothelial hyperplasia and the proportion of immunosuppressant among groups(P<0.05). There was statistically significant difference in the good rate of renal function among the three groups, and the good rate of renal function in the large crescentic group was significantly lower than those of the other two groups(all P<0.01). Multivariate Cox regression model analysis showed that the baseline eGFR level, the proportion of patients complicated with greater crescents and the proportion of patients with mixed crescents were independent prognostic factors of Henoch-Schonlein purpura nephritis(P<0.05). Conclusion There are significant differences in clinical characteristics of the pathological types of Henoch-Schonlein purpura nephritis, and its clinical prognosis may be affected by the baseline eGFR level and the proportion of complicated large crescents.

关 键 词：肾炎 预后 影响因素 新月体 EGFR 紫癜 

分 类 号：R692[医药卫生—泌尿科学]