IgA肾病血脂异常与临床病理分析

Analysis on clinicopathological features and dyslipidemia in IgA nephropathy

目的探讨血脂异常与IgA肾病临床及病理的关系。方法收集自2008年1月至2015年11月肾活检诊断为IgA肾病患者178例。分别使用Lee氏分级及牛津分级对IgA肾病患者进行病理分级。分别探讨血脂异常、高三酰甘油血症、高胆固醇血症与IgA肾病临床及病理之间的关系。结果 IgA肾病伴血脂异常尤其是伴高三酰甘油血症者,24h尿蛋白定量升高,有较高的血肌酐和较低的eGFR。IgA肾病伴血脂异常尤其是伴高三酰甘油血症者,肾小管萎缩和(或)间质纤维化者比例高(58.5%)。结论应加强对IgA肾病患者血脂异常的认识,积极地降脂治疗,延缓IgA肾病的进展。

Objective To explore the relationship between dyslipidemia with clinic and pathological features in lgA nephrop- athy. Methods A total of 178 IgA nephropathy diagnosed by biopsy from January 2008 to November 2015 were collected. Accord- ing to Lee＇s classification and Oxford classification;these patients were performed the pathological grades of IgA nephropathy. The relationship among dyslipidemia, hypertriglyceridemia, hypercholesterolemia and the clinical and pathological features of IgA ne- phropathy was respectively investigated. Results The patients with IgA nephropathy complicating dyslipidemia, particularly hyper- triglyceridemia, had higher 24-h urine protein,higher serum creatinine and lower eGFR. The patients with IgA nephropathy compli- cating dyslipidemia, especially hypertriglyceridemia; had the higher proportion of renal tubular atrophy and/or interstitial fibrosis （58.5 %）. Conclusion The understanding of dyslipidemia in the patients with IgA nephropathy should be strengthened, lipid-low- ering treatment should be actively conducted to delay the progress of IgA nephropathy.