IgA肾病患者尿蛋白谱与中医辨证分型的关系  

Relationship between urine protein spectrum and Traditional Chinese Medicine syndrome differentiation in patients with IgA nephropathy

作　　者：李丽 代建风 刘永芳 陈帮明 聂文迪 刘星宇 刘晖扬 LI Li;DAI Jianfeng;LIU Yongfang;CHEN Bangming;NIE Wendi;LIU Xingyu;LIU Huiyang(Department of Emergency,Jiujiang Traditional Chinese Medicine Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市中医医院急诊科,江西九江332000

出　　处：《当代医学》2024年第8期1-5,共5页Contemporary Medicine

基　　金：江西省中医药管理局科技计划(2020A0145)。

摘　　要：目的探讨IgA肾病患者尿蛋白谱与中医辨证分型的关系。方法选取2020年6月至2021年3月九江市中医医院收治的100例IgA肾病患者作为观察组,根据《IgA肾病诊断、辨证分型和疗效评定》结合临床实际将观察组分为脾肺气虚组(n=26)、脾肾气虚组(n=17)、气阴两虚组(n=24)、肝肾阴虚组(n=14)、脾肾阳虚组(n=19),另选取本院同期健康体检者100名作为对照组。所有研究对象均行尿转铁蛋白(TRF)、IgG、补体3(C3)、α2-巨球蛋白(α2-MG)检测,比较观察组亚组与对照组尿TRF、IgG水平及尿C3、α2-MG阳性率,分析尿TRF、IgG、C3及α2-MG检测对肝肾阴虚及脾肾阳虚证型IgA肾病的诊断价值。结果观察组亚组与对照组尿TRF、IgG水平比较差异有统计学意义(P<0.05)。观察组亚组尿TRF、IgG水平均高于对照组,且气阴两虚组、肝肾阴虚组、脾肾阳虚组尿TRF、IgG水平均高于脾肺气虚组、脾肾气虚组,肝肾阴虚组、脾肾阳虚组高于气阴两虚组,脾肾阳虚组高于肝肾阴虚组,差异有统计学意义(P<0.05);脾肺气虚组与脾肾气虚组尿TRF、IgG水平比较差异无统计学意义。观察组亚组与对照组尿C3、α2-MG阳性率比较差异有统计学意义(P<0.05)。气阴两虚组、肝肾阴虚组、脾肾阳虚组尿C3、α2-MG阳性率均高于对照组、脾肺气虚组,且肝肾阴虚组、脾肾阳虚组高于脾肾气虚组,肝肾阴虚组、脾肾阳虚组尿C3阳性率均高于气阴两虚组,脾肾阳虚组尿C3阳性率高于肝肾阴虚组,尿α2-MG阳性率高于气阴两虚组,差异有统计学意义(P<0.05),其他各组两两比较差异均无统计学意义。尿TRF、IgG、C3、α2-MG诊断肝肾阴虚型IgA肾病的AUC分别为0.848、0.775、0.629、0.757,尿TRF、IgG、C3、α2-MG诊断效能较佳。尿TRF、IgG、C3、α2-MG诊断脾肾阳虚型IgA肾病的AUC分别为0.880、0.852、0.524、0.581,尿TRF、IgG诊断效能较佳,尿C3、α2-MG诊断效能较差。结论不同中医辨证分型IObjective To explore the relationship between urine protein spectrum and Traditional Chinese Medicine syndrome(TCM)differentia-tion in patients with IgA nephropathy.Methods 100 patients with IgA nephropathy who were admitted to Jiujiang Traditional Chinese Medicine Hos-pital from June 2020 to March 2021 were selected as the observation group,and the observation group was divided into the spleen-lung Qi deficiency group(n=26),the spleen-kidney Qi deficiency group(n=17),the Qi-Yin deficiency group(n=24),the liver-kidney Yin deficiency group(n=14)and the spleen-kidney Yang deficiency group(n=19)according to Diagnosis,Syndrome Differentiation and Efficacy Evaluation of IgA Nephropathy com-bined with clinical practice,and another 100 healthy physical examination subjects in our hospital during the same period were selected as the control group.The levels of urinary transferrin(TRF)and IgG,complement 3(C3)andα2-macroglobulin(α2-MG)were detected in all subjects,and the levels of urinary TRF and IgG and the positive rates of urinary C3 andα2-MG were compared among the observation group subgroups and the control group,the diagnostic value of urinary TRF,IgG,C3 andα2-MG on IgA nephropathy with different TCM syndromes was analyzed.Results There were sig-nificant differences in urinary TRF and IgG levels among the observation group subgroups and the control group(P<0.05).The levels of urinary TRF and IgG in the observation group subgroups were higher than those in the control group,and the levels of urinary TRF and IgG in the Qi-Yin de-ficiency group,the liver-kidney Yin deficiency group and spleen-kidney Yang deficiency group were higher than those in the spleen-lung Qi deficien-cy group and the spleen-kidney Qi deficiency group,the liver-kidney Yin deficiency group and the spleen-kidney Yang deficiency group were higher than in the Qi-Yin deficiency group,the spleen-kidney Yang deficiency group was higher than liver-kidney Yin deficiency group,the differences were statistically significant(P<0.05);there was no signific

关 键 词：尿转铁蛋白 尿IGG 尿补体3 尿α2-巨球蛋白 IGA肾病 

分 类 号：R692[医药卫生—泌尿科学]