过敏性紫癜性肾炎患者病理分级与临床表型的相关性分析

Correlation Analysis of Pathological Grade and Clinical Features in Patients with Henoch-Schonlein Purpura Nephritis

目的:探讨过敏性紫癜性肾炎(HSPN)患者病理分级与临床特点相关性。方法:选取2010年4月至2016年7月39例于深圳市第二人民医院经肾穿刺活检确诊为HSPN患者,按国际儿童肾脏病研究协作组(ISKDC)的分级分为I级组、II级组与Ⅲ+ Ⅳ级组;分析过敏性紫癜性患者病理分级与年龄、肾功能损害、尿蛋白水平、免疫荧光免疫球蛋白A(Ig A)分级、免疫荧光C3等临床及病理指标的相关性。采用卡方检验及相关性分析。结果:相关性分析结果提示,过HSPN患者病理分级与年龄(χ2=2.468,r=0.376,P=0.018),肾功能损害(χ~2=2.343,r=0.359,P=0.025),尿蛋白水平(χ~2=2.945,r=0.436,P=0.006),血尿素氮(BUN)(r=0.482,P=0.002),三酰甘油(TG)(r=0.474,P=0.002)及低密度脂蛋白(LDL–C)(r=0.491,P=0.002)呈正相关关系,与血免疫球蛋白G(Ig G)水平呈负相关关系(r=–0.346,P=0.033)。结论:HSPN患者病理分级与年龄、肾功能损害、24 h尿蛋白水平、BUN、TG、LDL–C、Ig G等具有密切相关,因而,临床上可以通过过敏性紫癜患者病理损伤程度来预测其临床表现及预后。

Objective To explore the correlation between pathological grade and clinical features in patients with Henoch- Schonlein purpura nephritis. Methods Thirty-nine patients with Henoch-Schonlein purpura nephritis were divided into group I, group II and group Ⅲ＋Ⅳ according to ISKD classification. The relationship of pathological grade and clinical or pathological features, such as age, impairment of renal function, 24h urinary protein levels, immunofluorescence levels of IgA and C3 in patients with Henoch-Schonlein purpura were analyzed. Chisquare test and correlation analysis were used for data management. Results The correlation analysis showed that the pathological grade were positively correlated with age （X^2 = 2.468, r = 0.376, p = 0.018）, renal dysfunction （X^2 =2.343, r = 0.359, p = 0.025）, urinary protein （X^2= 2.945, r = 0.402, p = 0.002）, BUN （r = 0.482, p = 0.002）, TG （r = 0.474, p = 0.002） and LDL （r = 0.491, p = 0.002） in patients with Henoch-Schonlein purpura nephritis. However, serum IgG level was inversely correlated with pathological grade （r = -0.346, p = 0.033） in patients with Henoch-Schonlein purpura nephritis. Conclusion The pathological grading of patients with Henoch-Schonlein purpura nephritis was closely related to age, renal function damage, 24-hour urine protein, BUN, TG, LDL and IgG. Therefore, we can through the degree of pathological damage to predict clinical manifestation and prognosis in patients with Henoch-Schonlein purpura.