IgA肾病伴贫血患者危险因素的相关分析  

Associations of risk factors in IgA nephropathy patients with anemia

作　　者：朱丽爽 唐阁[1,2] 黄伟 祝昌昊 朱雅奇 李文婷 ZHU Lishuang;TANG Ge;HUANG Wei;ZHU Changhao;ZHU Yaqi;LI Wenting(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学第一附属医院,天津300381 [2]国家中医针灸临床医学研究中心,天津300381 [3]天津中医药大学研究生院,天津301617

出　　处：《中国实验诊断学》2025年第4期414-418,共5页Chinese Journal of Laboratory Diagnosis

基　　金：国家自然科学基金青年科学基金(82004316);国家自然科学基金青年科学基金(81503393)。

摘　　要：目的探讨IgA肾病(IgAN)伴贫血发生的相关危险因素。方法回顾性选取天津中医药大学第一附属医院经肾活检穿刺确诊的IgA肾病病例79例为研究对象,其中伴贫血44例,非贫血35例,收集相关基本信息、实验室理化指标进行回顾性分析。将患者分为贫血组与非贫血组,比较两组间血红蛋白浓度(HGB)、空腹血糖(FBG)、血肌酐(Scr)、24 h尿蛋白定量(24-utp)、D-D聚体(D-Dimer)、PT(凝血酶原时间)、全段甲状旁腺素(iPTH)、二氧化碳结合力(CO_(2)CP)、血钙(Ca)、血磷(P)、白蛋白(ALB)、甘油三酯(TG)、总胆固醇(TC)、尿素(BUN),并采用Pearson相关性分析、多因素logistic回归分析筛选IgAN伴发贫血的危险因素。结果IgAN贫血组与非贫血组相关化验指标比较,非贫血组HGB、CO_(2)CP、TC、Ca较贫血组数值更高,非贫血组D-Dimer、Scr、PT、ALB、P、BUN较贫血组数值更低,差异均有统计学意义(P<0.05);Pearson分析表明HGB与CO_(2)CP、ALB、TC、Ca呈正相关(r=0.541,r=0.294,r=0.316,r=0.404,P<0.05),HGB与D-Dimer、Scr、P、BUN呈负相关(r=-0.440,r=-0.627,r=-0.556,r=-0.654,P<0.05);Logistic回归分析表明PT、D-Dimer,Ca为LgAN发生贫血的独立影响因素。结论IgAN伴发贫血患者应定期监测相关指标,为降低IgAN贫血事件的发生应加强肾功能监测,严格控制PT、D-Dimer,密切监测血Ca,尽可能改善高凝、钙代谢紊乱状态。Objective To explore the relevant risk factors for IgAN with anemia patients.Methods We extracted 79medical records of IgAN confirmed by renal biopsy and puncture at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2020to September 2023.Among them,there were 44medical records in the anemia group and 35medical records in the non-anemia group.By comparing the hemoglobin concentrations(HGB),fasting blood glucose(FBG),blood creatinine(Scr),24-hour urine protein quantification(24-utp),D-dimer(Ddimer),prothrombin time(PT),whole parathyroid hormone(iPTH),carbon dioxide binding capacity(CO_(2)CP),blood calcium(Ca),blood phosphorus(P),albumin(ALB),triglycerides(TG),total cholesterol(TC),and urea(BUN)between two groups,Pearson correlation analysis and multivariate logistic regression analysis were used to screen for risk factors for IgAN associated anemia.Results Comparison of laboratory indicators between the IgAN anemia group and the non-anemia group showed that the non-anemia group had higher values of HGB,CO_(2)CP,TC,and Ca compared to the anemia group,while the non-anemia group had lower values of D-Dimer,Scr,PT,ALB,P,and BUN compared to the anemia group,and the differences were statistically significant(all P values<0.05).Meanwhile,Pearson correlation analysis showed that HGB was positively correlated with CO_(2)CP,ALB,TC,TG,Ca(r=0.541,r=0.294,r=0.316,r=0.223,r=0.404,all P values<0.05)while HGB was negatively correlated with D-Dimer,Scr,iPTH,P,and BUN(r=-0.440,r=-0.627,r=-0.370,r=-0.556,r=-0.654,all P values<0.05).Logistic regression analysis showed that PT,D-Dimer,and Ca were independent influencing factors for the occurrence of anemia in IgAN.Conclusion IgAN patients with accompanying anemia should regularly monitor relevant indicators.To reduce the incidence of anemia events,IgAN should strengthen renal function monitoring,strictly control PT and D-dimer,timely supplement blood Ca,and try to improve hypercoagulability and calcium deficiency as much as possible.

关 键 词：IGA肾病 贫血 危险因素分析 LOGISTIC回归分析 

分 类 号：R692[医药卫生—泌尿科学]