不同性别IgA肾病患者相关临床指标及病理特点对比

Comparative Analysis of Clinical and Pathological Features of Patients with Different Sex IgA Nephropathy

目的通过对不同性别IgA肾病患者临床指标及病理特点的对比,了解性别间相关指标的差异,为临床积极有效的治疗该病提供依据。方法回顾性分析2017年1月1日~2018年8月30日我院经肾穿刺活检确诊的361例IgA肾病患者的临床资料,比较不同性别IgA肾病患者的临床资料、危险度分级、病理分级及免疫荧光分型。结果不同性别IgA肾病患者年龄、病程、舒张压、水肿、血尿、蛋白尿、血尿+蛋白尿、白蛋白、IgA、IgG、IgM、IgE、C3、C4、IgA/C3、肾小球滤过率、血钾、血钙、血磷、APTT、PT、FIB、左肾及右肾大小比较,差异无统计学意义(P>0.05);男性收缩压、血压高、肾功异常占比、胱抑素、肌酐、尿素、尿酸、甘油三脂、胆固醇、血钠、尿蛋白定量高于女性,差异有统计学意义(P<0.05)。不同性别IgA肾病患者在1~3级占比比较,差异无统计学意义(P>0.05);男性IgA肾病患者在4级占比多于女性,差异有统计学意义(P<0.05)。不同性别IgA肾病患者病理分级比较,差异无统计学意义(P>0.05)。不同性别IgA肾病患者在IgA+IgM+C3、IgA+IgM+IgG、IgA+IgM+IlgG+C3占比比较,差异无统计学意义(P>0.05);男性IgA肾病患者在IgA+IgG+C3、IgA+C3分型中占比多于女性,差异有统计学意义(P<0.05)。结论男性IgA肾病的发病人数多于女性,且在IgA肾病中,男性的肾功能较女性差,推测其预后可能较差,因此当男性确诊为IgA肾病后,应更加关注其临床指标及病理相关指标,及早干预、及早治疗,制定合理地个性化治疗方案,延缓其进展。

Objective To compare the clinical indicators and pathological features of patients with different gender IgA nephropathy,and to understand the differences between gender-related indicators,so as to provide a basis for clinically effective treatment of the disease.Methods The clinical data of 361 patients with IgA nephropathy diagnosed by renal biopsy from January 1,2017 to August 30,2018 were retrospectively analyzed.The clinical data,risk grading and pathological grading of patients with different gender IgA nephropathy were compared.And immunofluorescence typing.Results Age,duration,diastolic blood pressure,edema,hematuria,proteinuria,hematuria+proteinuria,albumin,IgA,IgG,IgM,IgE,C3,C4,IgA/C3,glomerular filtration rate,IgA nephropathy there was no significant difference in serum potassium,serum calcium,blood phosphorus,APTT,PT,FIB,left kidney and right kidney(P>0.05);Male systolic blood pressure,high blood pressure,abnormal renal function,cystatin,creatinine,urea,uric acid,triglyceride,cholesterol,blood sodium,urine protein were higher than females,the difference was statistically significant(P<0.05).There was no significant difference in the proportion of IgA nephropathy patients with grade I to grade 3(P>0.05).The proportion of male IgA nephropathy patients was higher than that of females at 4th grade,the difference was statistically significant(P<0.05).There was no significant difference in pathological grade between patients with different gender IgA nephropathy(P>0.05).There were no significant differences in the proportion of IgA+IgM+C3,IgA+IgM+IgG,IgA+IgM+IgG+C3 in patients with different gender IgA nephropathy(P>0.05).IgA+IgG+C3 in male IgA nephropathy patients the proportion of IgA+C3 classification was higher than that of females,the difference was statistically significant(P<0.05).Conclusion The incidence of IgA nephropathy in men is higher than that in women.In IgA nephropathy,the renal function of men is worse than that of women.It is speculated that the prognosis may be poor.Therefore,when men are diagnosed with IgA nephropathy,they should pay more attention to their clinical indicators and pathological correlation.Indicators,early intervention,early treatment,and rationalized personalized treatment programs to delay their progress.