微小病变型肾病患者血尿酸/血肌酐比值与临床指标及肾脏病理的相关性  

Association of serum uric acid to serum creatinine ratio with clinical indicators and renal pathology in patients with minimal change nephropathy

作　　者：陈怡渝 程琳 黄朝晖 高勤 何常 CHEN Yiyu;CHENG Lin;HUANG Zhaohui;GAO Qin;HE Chang(Department of Rheumatology and Immunology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550000,Guizhou,China;School of Clinical Medicine,Guizhou Medical University,Guiyang 550000,Guizhou,China;Department of Pathology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550000,Guizhou,China)

机构地区：[1]贵州医科大学附属医院风湿免疫科,贵州贵阳550000 [2]贵州医科大学临床医学院,贵州贵阳550000 [3]贵州医科大学附属医院病理科,贵州贵阳550000

出　　处：《贵州医科大学学报》2024年第10期1514-1520,1535,共8页Journal of Guizhou Medical University

基　　金：贵州省卫生健康委科学技术基金项目(gzwkj2022-002)。

摘　　要：目的探讨微小病变型肾病(MCD)患者的血尿酸(UA)/血肌酐(Cr)比值与其临床指标、肾脏病理的相关性。方法选取肾穿刺活检确诊为MCD的患者109例,按照UA/Cr大小分为低UA/Cr组(n=54)和高UA/Cr组(n=55),收集2组患者的临床资料,采用酶法、Jaffe法检测患者住院首日静脉血生化指标及24 h尿蛋白定量(24 h-UP)、浆膜腔积液情况以及肾脏病理特征,采用多重线性回归分析MCD患者UA/Cr水平的影响因素。结果高UA/Cr组MCD患者的纤维蛋白原(FIB)、D-二聚体(D-D)、UA、肾小球滤过率(eGFR)水平高于低UA/Cr组,Cr水平低于低UA/Cr组,差异有统计学意义(P<0.05);高UA/Cr组MCD患者肾小球肥大比例高于低UA/Cr组,差异有统计学意义(P<0.05);多重线性回归模型结果示,MCD患者肾小管萎缩/间质纤维化与UA/Cr呈负相关(β=-0.332,95%CI为-1.798~-0.515,P=0.001),FIB与UA/Cr呈正相关(β=0.263,95%CI为0.067~0.379,P=0.006)。结论UA/Cr水平可反映MCD患者高凝状态、血栓形成及肾小管间质损害风险。Objective To investigate the correlation of serum uric acid(UA)/serum creatinine(Cr)ratio with clinical indicators and renal pathology in patients with minimal change nephropathy(MCD).Methods A total of 109 patients diagnosed as MCD via renal biopsy were selected and categorized into low UA/Cr group(n=54)and high UA/Cr group(n=55)based on their UA/Cr levels.Clinical data from two groups of patients were collected.Enzymatic method and Jaffe method were used to examine venous blood biochemical indicators of the patients on the first day of hospitalization,24-hour urinary protein quantification(24 h-UP),serosal fluid accumulation and renal pathological characteristics on the first day of hospitalization.Multiple linear regression analysis was used to analyze the influencing factors of UA/Cr levels in the patients with MCD.Results The levels of FIB,D-dimer(D-D),UA,and estimated glomerular filtration(eGFR)rate were higher in high UA/Cr group than those in low UA/Cr group,while Cr level was lower than that in low UA/Cr group(P<0.05).The proportion of glomerular hypertrophy was significantly higher in the patients with MCD in high UA/Cr group than that in low UA/Cr group(P<0.05).Multiple linear regression model analysis showed that renal tubular atrophy/interstitial fibrosis of the patients with MCD was negatively correlated with UA/Cr(β=-0.332,95%CI was from-1.798 to-0.515,P=0.001),while FIB was positively correlated with UA/Cr(β=0.263,95%CI was from 0.067 to 0.379,P=0.006).Conclusion UA/Cr level can serve as an indicator for assessing the risk of hypercoagulability,thrombosis and tubulointerstitial damage in the patients with MCD.

关 键 词：肾病综合征 血尿酸/血肌酐 微小病变型肾病 高凝状态 肾小管萎缩/间质纤维化 肾脏病理 

分 类 号：R446.1[医药卫生—诊断学]