贫血加重IgA肾病患者的临床和病理改变

Anemia aggravates clinical and pathological changes in patients with IgA nephropathy

目的分析IgA肾病合并贫血患者的临床病理特征。方法收集经肾活检确诊的IgA肾病患者临床资料409例，按照贫血与否分为非贫血组和贫血组，回顾性分析两组患者的临床和病理资料。结果与非贫血组比较，贫血组患者的肾小球损伤和肾小管间质萎缩程度较重、24h尿蛋白增多和eGFR降低。Spearman相关分析结果显示，血红蛋白、eGFR与肾脏病理损伤呈负相关（P〈0．05），血尿酸、24h尿蛋白与肾脏病理损伤呈正相关（P〈0．05）。多因素Logistic回归分析发现贫血是肾小管间质萎缩的独立危险因素。结论IgA肾病合并贫血患者的临床和病理损伤重于IgA肾病非贫血的患者，贫血参与IgA肾病的进展。

Objective To analyze the changes of clinical and pathological features in the patients of IgA nephropathy with anemia. Methods Four hundred and nine patients of IgA nephropathy diagnosed by renal biopsy were classified into two groups： IgA nephropathy with nonanemia （group 1） and IgA nephropathy with anemia （group 2）. Changes were studied retrospectively between the groups. Results Serum hemoglobin level was correlated with the clinical parameters of IgA nephropathy. Compared to group 1, changes in group 2 were as followed： serum creatinine increased, eGFR decreased, proteinuria increased; the global sclerosis, segmental sclerosis, crescents and tubulointerstitial lesions worsened. The glomerular and tubulointerstitial lesions were negatively correlated with serum hemoglobin and eGFR, but positively correlated with serum uric acid and proteinuria （P〈0.05）. Multivariate Logistic regression analysis revealed that anemia was an independent risk factor for the tubulointerstitial lesion. Conclusion Clinical feature and pathological damages in the patients of IgA nephropathy with anemia are more serious than those with non-anemia.