IgA肾病患者尿1，25（OH）2D3水平与临床预后的相关性

Correlation of urinary 1,25（ OH）2D3 level with clinical prognosis in patients with IgA nephropathy

目的 探讨IgA肾病患者尿1,25-二羟基维生素D3[1,25（OH）2D3]水平与肾组织病理损伤程度的相关性,并进行危险因素分析.方法 选取IgA肾病患者72例作为实验组,并进行临床和病理分级（Hass分级）,另选取同期健康体检人群60例为对照组.分析尿1,25（OH）2D3水平与IgA肾病患者临床病理损伤程度的相关性,并于随访后行肾脏生存分析.结果 随着Hass分级加重,IgA肾病患者尿1,25（OH）2D3水平逐渐降低（P＜0.01）;尿1,25 （OH） 2D3水平与24 h尿蛋白量、肾小球滤过率（eGFR）、阶段硬化或粘连比例、增生硬化比例均相关（P＜0.05）.多因素Cox回归分析模型分析显示,尿1,25 （OH） 2D3水平是肾脏病进展的独立危险因素（P=0.035）.结论 尿1,25 （OH） 2D3水平与IgA肾病患者肾组织病理损伤密切相关,且是能预测IgA肾病患者肾脏病变进展的独立危险因素.

Objective To investigate the correlation between urinary 1,25-dihydroxyvitamin D3 [1,25 （OH）2D3] level and the degree of pathological injury of renal tissue in IgA nephropathy patients,and analyze the risk factors.Methods Seventy-two IgA nephropathy patients were selected as experimental group,and they were classified according to clinical and pathological grading （Hass classification）.Sixty healthy people were selected as control group at the same time.The correlation between the urinary 1,25 （OH）2D3 level and the clinicopathological data of patients with IgA nephropathy was analyzed,and the renal survival analysis was performed after the follow-up.Results The urinary 1,25（OH）2D3 level decreased in IgA nephropathy patients with the Hass grades aggravating （P〈0.01）.The urinary 1,25 （OH）2D3 level was associated with 24 h urinary protein quantity,glomerular filtration rate （eGFR）,the ratio of segmental glomerulosclerosis or adhesion and the ratio of proliferative glomerulosclerosis （P 〈 0.05）.The multivariate Cox regression analysis model showed that urinary 1,25 （OH）2D3 level was an independent risk factor of renal disease progression （P =0.035）.Conclusions The level of urinary 1,25 （OH）2D3 is closely related to the pathological injury of renal tissue in patients with IgA nephropathy,and it is an independent risk factor that can predict the progress of kidney disease in patients with IgA nephropathy.