IgA肾病与过敏性紫癜性肾炎临床特征对比分析

Comparative analysis of clinical characteristics between IgA nephropathy and Henoch-Schonlein purpura nephritis

目的比较IgA肾病与过敏性紫癜性肾炎(HSPN)的临床表现的特点。方法收集2005-01~2014-12在我院经肾活检病理检查确诊且资料较完整的IgA肾病(IgAN组)及HSPN(HSPN组)患者的临床资料,回顾性分析两组患者的临床表现、实验室检查指标及临床表现类型等并进行比较。结果①两组患者的性别构成比较差异无统计学意义(P>0.05),均以男性多见;IgAN组的年龄较HSPN组大(P<0.001)。②IgAN组及HSPN组血尿的发生率分别是74.16%及83.79%,两者存在差异(P<0.005),高血压(包括收缩压及舒张压)的发生两者存在差异(P<0.005)。③除血肌酐IgAN组高于HSPN组外,尿蛋白、血浆白蛋白、胆固醇指标,两者差异无统计学意义(P>0.05)。④血中IgG及IgA浓度均为IgAN组高于HSPN组(P<0.05),而IgM、C_3、C_4两组差异均无统计学意义(均P>0.05)。⑤两组患者临床表现均以慢性肾炎常见,其次为肾病综合征,HSPN组急性肾炎综合征的患者比例高于IgA肾病组(P<0.05)。⑥疾病危险度3级及4级患者的总数在IgAN组为809例占45.35%,而HSPN组117例占35.78%,差异有统计学意义(P<0.05)。结论①两组疾病均男性多见,IgAN的年龄较大。②两组患者的血尿发生率均高,但HSPN组更高,IgAN患者血压(包括收缩压及舒张压)、疾病危险度分级、血中的IgG及IgA水平高于HSPN组。③两组临床表现均以慢性肾炎常见,其次为肾病综合征。

Objective To compare the clinical features of IgA nephropathy（ IgAN） and Henoch- Schonlein purpura nephritis（HSPN）.Methods Clinical data of patients with IgAN（IgAN group） or HSPN（HSPN group） diagnosed by renal biopsy from January 2005 to December 2014 were collected.The clinical manifestations,laboratory indexes and clinical disease types in the two groups were analyzed and compared.Results ①There was no significant difference in the gender composition between the two groups（ P 0.05）,and the percentage of male was both comparatively higher in two groups.The patients in IgAN group was older than the ones in HSPN group（ P0.001）.②The incidence of hematuria in IgAN group and HSPN group were 74.16% and 83.79%,respectively,and the difference was statistically significant（ P0.05）.Similar results were also found in the occurrence of hypertension（ systolic and diastolic blood pressure）（ P0.005）.③There was no statistical difference between the two groups about urinary protein,plasma albumin and cholesterol.Serum creatinine level was higher in IgAN group than in HSPN group.④Serum IgG and IgA concentrations were higher in IgAN group than that in HSPN group（ P0.05）,while no statistical difference was found in serum IgM,C_3 and C_4 between two groups（ P0.05）.⑤The proportion of chronic glomerulonephritis was the highest in both groups,followed by nephrotic syndrome.The incidence of acute nephritis syndrome was higher in HSPN group than that in IgAN group（ P0.05）.⑥There was 809（45.35%） patients with grade 3 and grade 4 in IgAN group and 117（35.78%） patients in HSPN group（ P0.05）.Conclusion ①The IgAN and HSPN are more common in male.IgAN patients are older than HSPN patients.②The incidence of hematuria is both comparatively high in the two groups,but HSPN patients are more likely to have hematuria.The blood pressure,disease risk and serum IgG and IgA in IgAN patients are higher than those in HSPN patients.③The proportion of chronic glomerulonephritis is the highest in both groups,followed by nephrotic syndrome.