525例伴血脂异常IgA肾病患者的临床病理分析

Clinico-pathological analysis of 525 IgA nephropathy patients with dyslipidemia

目的:探究不同血脂类型的IgA肾病患者的临床病理表现的差异.方法:采用横断面研究设计,纳入525例IgA肾病患者的性别、基线年龄、基线病程、基线血压、高血压病史、血肌酐、eGFR、尿酸、24 h小时尿蛋白定量、尿红细胞计数、血清白蛋白、血脂、Katafuchi半定量病理积分系统(包括小球积分、小管-间质积分、血管积分)等临床病理资料,根据血脂结果将患者分为血脂正常组、高胆固醇血症组、高甘油三酯血症组、低高密度脂蛋白组,分别比较各组临床病理指标的差异.结果:高甘油三酯血症组的间质纤维化积分、小管萎缩积分、小管间质积分、血管壁增厚积分、血管积分、katafuchi总积分高于血脂正常组;其小球增殖积分低于高胆固醇血症组;而血管壁增厚积分高于高胆固醇血症组.结论:不同血脂异常类型的IgA肾病患者的病理损害程度并不完全相同,其中高甘油三酯血症可能对肾脏病理改变影响较大.

Objective:To explore the clinico-pathological characteristics of IgA nephropathy patients with different types of blood lipid metabolism.Methods:This cross-sectional study enrolled 525 IgA nephropathy patients,and the baseline datas of gender,age,disease course,blood pressure,history of hypertension,serum creatinine,uric acid,urinary protein excretion,urine erythrocyte,serum albumin,triglyceride,cholesterol,high-density lipoprotein,and Katafuchi semi-quantitative scoring system(including glomerular score,tubulointerstitial score,vascular score)were collected.According to the blood lipid levels,the patients were divided into normal blood lipid group,hypercholesterolemia group,hypertriglyceridemia group and low high-density lipoprotein group.The differences in clinical pathological index between the two groups was compared.Results:The Interstitial fibrosis score,tubule atrophy score,tubule interstitial score,vessel wall thickening score,vascular score and katafuchi total score in the hypertriglyceridemia group were higher than those in the normal lipid group;the glomerular proliferation score was lower than the hypercholesterolemia group,and the vessel wall thickening score in the hypertriglyceridemia group were higher than those in the hypercholesterolemia group.Conclusion:The pathological damage degree of IgA nephropathy patients with different types of dyslipidemia is not exactly the same.Hypertriglyceridemia may have a greater impact on renal pathological changes.