血小板与白蛋白比值在IgA肾病中的临床价值  

Clinical Value of the Platelet-to-Albumin Ratio for IgA Nephropathy

作　　者：宋爽爽 杜宇[2] 田加坤 张磊[2] 张立元[2] 曹微[2] SONG Shuangshuang;DU Yu;TIAN Jiakun;ZHANG Lei;ZHANG Liyuan;CAO Wei(The First People's Hospital of Lianyungang,Jinzhou Medical University Postgraduate Training Base,Lianyungang 222000,China;不详)

机构地区：[1]锦州医科大学研究生培养基地连云港市第一人民医院,江苏连云港222000 [2]连云港市第一人民医院肾内科,江苏连云港222000

出　　处：《中国医学创新》2024年第13期15-20,共6页Medical Innovation of China

摘　　要：目的:探讨血小板与白蛋白比值(PAR)和IgA肾病(IgAN)患者的临床病理的关系。方法:回顾性收集2017年6月—2022年12月于连云港市第一人民医院肾内科行肾穿刺确诊的97例原发性IgAN患者的临床病理资料。根据PAR百分位数将患者分为两组,PAR低水平组(≤5.63)49例和PAR高水平组(>5.63)48例。结果:PAR高水平组的PLT、胱抑素C、血尿酸、白细胞、24 h尿蛋白水平均高于PAR低水平组(P<0.05);PAR高水平组系膜细胞过多(M)、毛细血管内细胞过多(E)、肾小管萎缩和间质纤维化(T)均多于PAR低水平组(P<0.05)。PAR高水平组患者的血清白蛋白低于PAR低水平组(P<0.05)。PAR低水平组的病理分级以Ⅰ+Ⅱ级为主,PAR高水平组的病理分级以Ⅳ+Ⅴ级为主,两组病理分级差异有统计学意义(χ^(2)=23.301,P<0.001)。结论:PAR可能反映IgA肾病患者疾病炎症状态及活动性,同时对高PAR水平的IgAN患者可予以更有效的治疗方案,从而改善肾脏结局。Objective:To explore the relationship between platelet-to-albumin ratio(PAR)and clinicopathology of patients with IgA nephropathy(IgAN).Method:The clinicopathological data of 97 patients with primary IgAN who were diagnosed by renal puncture in the Department of Nephrology of the First People's Hospital of Lianyungang from June 2017 to December 2022 were collected retrospectively.Patients were categorized into two groups based on PAR percentile,49 patients in the low PAR group(≤5.63)and 48 patients in the high PAR group(>5.63).Result:The levels of PLT,cystatin C,blood uric acid,white blood cells and 24 h urinary protein in high PAR group were higher than those in low PAR group(P<0.05).Mesangial cell excess(M),capillary cell excess(E),renal tubule atrophy and interstitial fibrosis(T)in high PAR group were more than those in low PAR group(P<0.05).The serum albumin of high PAR group was lower than that of low PAR group(P<0.05).Pathologic grading in the low PAR group was dominated by gradeⅠ+Ⅱ,while that in the high PAR group was dominated by gradeⅣ+Ⅴ,the difference in pathologic grading between the two groups was statistically significant(χ^(2)=23.301,P<0.001).Conclusion:PAR may reflect the inflammatory state and activity of the disease in patients with IgA nephropathy,while IgAN patients with high PAR levels may be treated with more effective therapeutic regimens to improve renal outcomes.

关 键 词：IGA肾病 血小板与白蛋白比值 临床病理特征 

分 类 号：R692.31[医药卫生—泌尿科学]