牛津病理分类方法在IgA肾病中的临床应用研究

Study of the clinical applicability of the Oxford pathological classification for IgA nephropathy

目的探讨牛津病理分类方法对IgA肾病患者的临床适用性。方法收集120例IgA肾病患者的临床及病理资料,根据牛津病理分类方法中的系膜细胞增生(M)、节段性肾小球硬化(S)、毛细血管内细胞增生(E)、肾小管萎缩及间质纤维化(T)等4项病理指标分组,比较不同病理指标者的临床资料差异,分析牛津病理分类方法及Haas分型方法的相关性及其分别与尿蛋白定量及肾小球滤过率(GFR)的相关性。结果 M0组与M1组间IgA肾病患者平均动脉压、尿蛋白定量及血尿酸水平比较差异有统计学意义(P<0.05)。E0组与E1组间IgA肾病患者尿蛋白定量比较差异有统计学意义(P<0.05)。S0组与S1组间IgA肾病患者平均动脉压、尿蛋白定量、血尿酸、GFR及血脂水平比较差异有统计学意义(P<0.05)。T0组与T1/T2组间IgA肾病患者平均动脉压、尿蛋白定量、血尿酸、GFR及血甘油三酯比较差异有统计学意义(P<0.05)。牛津病理分类方法与Haas分型法呈正相关(r=0.747,P<0.05),并且均与IgA肾病患者的GFR、尿蛋白定量有关(P均<0.05)。结论牛津病理分类方法各个病理指标与IgA肾病临床指标相关。牛津病理分类方法与Haas分型方法具有良好的相关性,对IgA肾病具有临床适用性。

Objective To study the eorrelation between the Oxford classification and the Haas＇s clas- sification, and to analysis the relationship between pathological variables of the Oxford classification and clinical indicators. Methods Clinic and pathological datas of 120 patients diagnosed as primary IgA nephropathy were collected. The Oxford classification score （ mesangial hypercellularity score M0/M1, endocapillary hypercellu- larity score E0/E1, segmental glomerular sclerosis score SO/S1 and tubular atrophy and interstitial fibrosis score T0/T1/T2） and the Haas＇s classification （ I ~ V grade） were performed, . Correlation between Oxford classification and Haas＇s classification, their correlation with 24 hour urinary protein and glomerular filtration rate were estimated. , Samples were divide into： the M0 and M1 group, E0 and E1 group, SO and S1 group, TO and T1/T2 groups, according to the pathological various score of the Oxford classification, and were eom- pared with different clinical data. Results The Oxford classification was significantly correlated with the Haas＇s classification, （ r = 0. 747, P 〈 0. 05 ）. Both pathology classifications were negatively correlated with esti- mated glomerular filtration rate, and positively correlated with 24-hour urine protein with significant difference. 24 hours urinary protein, MAP and serum uric acid between M0 and M1 group were significantly different （P 〈 0. 05 ） ; 24 hours urinary protein between E0 and E1 group was significantly different （ P 〈 0. 05 ） ; 24 hours u- rinary protein, MAP, uric acid, estimated glomerular filtration rate and lipids were significantly different （ P 〈 0. 05 ） between SO and S1 group ; 24-hour urine protein, MAP, serum uric acid, glomerular filtration rate and blood triglyeeride are significantly different （ P 〈 0. 05 ） between the TO and T1/T2 group. Conclusion The Oxford classification has a positive correlation with the Haas＇s classification. It was applicable for clinical assess- ment. The pathological various of the Oxford classification were associated with clinical various.