高尿酸血症对不同蛋白尿水平IgA肾病患者临床及病理特征的影响  

Influence of hyperuricemia on clinical and pathological characteristics of Ig A nephropathy patients with different proteinuria levels

作　　者：袁茜宁 董怡晨 卿玲玲 赵瑾[3] 杨晓萍[2] Yuan Qianning;Dong Yichen;Qing Lingling(Medical College of Shihezi University,Shihezi 832008)

机构地区：[1]石河子大学医学院,新疆石河子832008 [2]石河子大学医学院第一附属医院肾病科,新疆石河子832008 [3]石河子大学医学院第一附属医院病理科,新疆石河子832008

出　　处：《中国现代医药杂志》2022年第12期16-22,共7页Modern Medicine Journal of China

摘　　要：目的探讨高尿酸血症对不同蛋白尿水平IgA肾病(IgAN)患者临床及病理特征的影响。方法选取2010年1月~2021年12月肾活检诊断为IgAN患者204例为研究对象,根据血尿酸(UA)水平将204例患者分为高尿酸血症组和血尿酸正常组,比较两组患者临床资料及病理特征。比较不同蛋白尿水平的IgAN患者高尿酸血症与临床及病理特征的关系。结果①高尿酸血症组患者男性较多,收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、空腹血糖(GLU)、血肌酐(Scr)、血尿素氮(BUN)、甘油三酯(TG)、总胆固醇(TC)、血清IgG、24h尿蛋白定量均较高,估算肾小球滤过率(eGFR)较低,系膜细胞增生(M型)、肾小管萎缩或间质纤维化(T型)的比例较高(P<0.05)。②Pearson相关分析显示,UA水平与SBP、DBP、MAP、GLU、Scr、BUN、TG、TC、24h尿蛋白定量呈正相关(P<0.05),与eGFR、血清IgG呈负相关(P<0.05)。③24h尿蛋白定量<1g组患者中,高尿酸血症患者男性多于女性,SBP、MAP、Scr、BUN、TG均较高,eGFR较低,系膜细胞增生较多(P<0.05)。④24h尿蛋白定量≥1g组患者中,高尿酸血症患者男性多于女性,SBP、DBP、MAP、GLU、Scr、BUN、TG、TC均较高,eGFR较低,肾小管萎缩或肾间质纤维化程度较重(P<0.05)。结论在IgAN患者中,高尿酸血症组患者的血压、血糖、血脂、血清IgG、24h尿蛋白定量均较高,系膜细胞增生、肾小管萎缩或间质纤维化的比例较高,肾功能较差,在24h尿蛋白定量≥1g患者中高尿酸血症的发生率较高,积极控制患者代谢相关指标能够减少蛋白尿,延缓IgAN的进展。Objective To explore the influence of hyperuricemia on clinical and pathological characteristics of IgA nephropathy(IgAN)patients with different proteinuria levels.Methods From Jan 2010 to Dec 2021,204 patients with IgAN diagnosed by renal biopsy were selected.According to the level of serum uric acid(UA),204 patients were divided into the hyperuricemia group and the normal serum uric acid group.The clinical and pathological characteristics'differences between the two groups were analyzed.To compare the relationship between hyperuricemia and clinic and pathology in IgAN patients with different proteinuria levels.Results①The patients with hyperuricemia were more male,and the systolic blood pressure(SBP),diastolic blood pressure(DBP),mean artery pressure(MAP),glucose(GLU),serum creatinine(Scr),blood urea nitrogen(BUN),triglyceride(TG),total cholesterol(TC),serum IgG and urinary protein quantification were higher.The estimated glomerular filtration rate(eGFR)was lower,and the proportion of mesangial hypercellularity(M type),tubular atrophy or interstitial fibrosis(T type)were higher(P<0.05).②Pearson correlation analysis showed that UA was positively correlated with SBP,DBP,MAP,GLU,Scr,BUN,TG,TC,and 24h urinary protein quantification.It was negatively correlated with eGFR and serum IgG.③In the patients with 24h urinary protein quantification<1g group,there were more males in the hyperuricemia group,SBP,MAP,Scr,BUN,and TG were higher,eGFR was lower,and mesangial hypercellularity was more(P<0.05).④Among the patients with 24h urinary protein quantification≥1g,there were more males in the hyperuricemia group,SBP,DBP,MAP,GLU,Scr,BUN,TG,TC were higher,eGFR was lower,renal tubule atrophy or renal interstitial fibrosis was more serious(P<0.05).Conclusion Among IgAN patients,the hyperuricemia group had higher blood pressure,blood glucose,blood lipid,serum IgG,and urinary protein quantification;there is a higher proportion of hypercellularity,renal rubular strophy or interstitial fibrosis,and inferiors renal function

关 键 词：IGA肾病 高尿酸血症 24H尿蛋白定量 

分 类 号：R692.31[医药卫生—泌尿科学] R589.7[医药卫生—外科学]