| 吕彩凤,郭珲.伴贫血 IgA肾病临床病理及预后研究[J].安徽医药,2024,28(2):313-316. |
| 伴贫血 IgA肾病临床病理及预后研究 |
| Study of clinicopathology and prognosis of IgA nephropathy with anemia |
| |
| DOI：10.3969/j.issn.1009-6469.2024.02.022 |
| 中文关键词: 肾小球肾炎， IGA 贫血 肾脏病理 肾脏预后 |
| 英文关键词: Glomerulonephritis,IGA Anemia Renal pathology Prognosis of kidney |
| 基金项目:山西省应用基础研究计划项目( 201901D1113777)；山西省回国留学人员科研教研项目( 2020-191) |
|
| 摘要点击次数: 328 |
| 全文下载次数: 175 |
| 中文摘要: |
| 目的探讨贫血与 IgA肾病临床、牛津病理分型及肾脏预后的关系，明确贫血是否为 IgA肾病进展的危险因素。方法选取 2020年 1月至 2021年 1月首次就诊山西医科大学第二医院并完善经皮肾穿刺活检术后诊断为 IgA肾病病人为研究对象。据血红蛋白( Hb)情况将病人分为贫血组和 Hb正常组。生存分析采用 Kapian-Meier法。比较两组临床特征、牛津病理( M、S、 E、T)分型及肾存活率的差异。通过二元 logistic回归方法分析贫血的影响因素。结果贫血组血肌酐( Scr)［171.50(76.75， 253.25)μmol/L比 76.50(64，90.75)μmol/L］、 24 h尿蛋白定量［2.49(1.24，4.07)g/d比 1.55(0.92，2.79)g/d］、慢性肾脏病( CKD)分期较 Hb正常组高，肾小球滤过率(eGFR)［36.50(21.75，96.25)mL·min-1 ·(1.73 m2)-1比 103(89.75，119.25)mL·min-1 ·(1.73 m2)-1］、血清白蛋白( Alb)［(31.90±6.95)g/L比( 37.81±6.89)g/L］较 Hb正常组低(P<0.05)。牛津病理( M、S、E、T)分型比较，贫血组 E、T分型较 Hb正常组高(P<0.05)。 Kapian-Meier生存分析结果显示，贫血组肾存活率较 HB正常组低( 38.9%比 75.0%，P<0.05)。回归分析结果显示牛津病理( T)分型是 IgA肾病合并贫血的独立危险因素， eGFR和 ALB是 IgA肾病合并贫血的保护因素(P<0.05)。结论贫血是 IgA肾病病人的常见并发症。在 IgA肾病病人中，贫血与肾功能下降、肾脏不良预后及间质损伤之间有显著相关性。贫血可能为 IgA肾病进展的独立危险因素。 |
| 英文摘要: |
| Objective To explore the relationship between anemia and the clinical, Oxford pathological classification and renal prog.nosis of IgA nephropathy, and to determine whether anemia is a risk factor for the progression of IgA nephropathy.Methods From Jan. uary 2020 to January 2021, patients who first visitedthe Second Hospital of Shanxi Medical University and were diagnosed as IgA ne.phropathy after percutaneous renal biopsy were selected as the research subiects. According to hemoglobin (Hb) level, patients were di.vided into anemia group and Hbnormal group.Kapian-Meier method was used for survival analysis. The difference of clinical character.istics, Oxford pathology (M,S,E,T) classification and renal survival rate between the two groupswere compared.The influencing factorsfor anemia were analyzed by binary logistic regression.Results The serum creatinine (Scr)[171.50(76.75,253.25)μmol/L vs. 76.50(64, 90.75)μmol/L], 24-hour urine protein level[2.49(1.24, 4.07)g/d vs. 1.55(0.92, 2.79)g/d] and chronic kidney disease (CKD) stage in theanemia group were higher than those in the normal Hb group, while glomerular filtration rate (eGFR) [36.50(21.75, 96.25)mL·min-1·(1.73 m2) -1 vs. 103(89.75, 119.25)mL·min-1·(1.73 m2) -1], serum albumin (Alb) [(31.90±6.95)g/L vs. (37.81±6.89)g/L] were lower than those in the normal Hb group (P<0.05). The comparison of Oxford pathological (M,S,E,T)classification showed that the E and T classifi. cation of anemia groupwere higher than thosein the normal Hb group (P<0.05).Kapian-Meier survival analysis showed that the renal sur. vival rate in the anemia group was lower than that in the normal Hb group (38.9% vs. 75.0%,P<0.05). The results of regression analysisshowed that the Oxford Pathology (T) classification was an independent risk factor for IgA nephropathy with anemia, and eGFR andALB were protective factors for IgA nephropathy with anemia(P<0.05). Conclusions Anemia is a common complication of IgA ne.phropathy. In patients with IgA nephropathy, anemia is significantly associated with decreased renal function, poor renal prognosis andinterstitial damage. Anemia may be an independent risk factor for the progression of IgA nephropathy. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
