儿童IgA肾病高尿酸血症与临床及牛津分型的关系

The relationships of hyperuricemia with clinical and Oxford classifications in children with IgA nephropathy

目的探讨儿童原发性IgA肾病血尿酸水平与临床、牛津病理分型之间的关系。方法回顾性分析213例原发性IgA肾病患儿的临床资料,根据患儿血尿酸水平分为血尿酸增高组(51例)及血尿酸正常组(162例),分析两组患儿临床指标和牛津病理分型的差异。结果血尿酸增高组患儿24 h尿蛋白定量、血肌酐水平、肾小球滤过率(eGFR)明显高于血尿酸正常组,差异有统计学意义(P均<0.05)。牛津病理分型显示,血尿酸增高组系膜细胞增生(M1)程度及肾小管萎缩/间质纤维化(T1-2)程度较血尿酸正常组严重,差异有统计学意义(P<0.01)。结论合并高尿酸血症的IgA肾病患儿临床指标、病理表现较血尿酸正常组严重,血尿酸增高可能是致儿童IgA肾病预后不良的重要因素之一。

Objective To investigate the relationships of hyperuricemia with clinical and Oxford classifications in children with IgA nephropathy.Methods Clinical data of 213 children with IgA nephropathy were retrospective analyzed. According to the levels of blood uric acid, these children were divided into two groups, hyperuricemia group (n?=?51) and normal uric acid group (n?=?162). Differences of clinical index and Oxford classiifcation between the two groups were observed. Results The 24 h urinary protein, level of serum creatinine, glomerular ifltration rate (eGFR) in hyperuricemia group were signiifcantly higher than those in normal group (P all?<?0.05). Oxford classiifcation showed that the degree of mesangial cell proliferation (M1) and renal tubular atrophy/interstitial ifbrosis (T1-2) in hyperuricemia group were more serious than in normal uric acid group (P all?<?0.01).Conclusions Children with IgA nephropathy combined with hyperuricemia were worse in clinical index and pathological manifestations. Increased serum uric acid may be one of the important factors that contribute to poor prognosis of children with IgA nephropathy.