血尿酸水平与IgA肾病进展的临床及病理的相关性研究

Correlation between serum uric acid level and the clinical and pathological features of the IgA nephropathy

目的分析血尿酸水平与IgA肾病进展的临床及病理的相关性,为临床治疗IgA肾病并改善预后提供理论依据。方法回顾性分析经肾活检确诊为原发性IgA肾病79例患者的一般情况、临床指标及病理资料,根据血尿酸水平将患者分成血尿酸升高组及血尿酸正常组,分析2组一般情况、临床指标及病理特点。结果与血尿酸正常组患者相比较,血尿酸升高组患者的肌酐水平明显升高(P<0.05);2组患者24 h尿蛋白定量、血红蛋白、血清白蛋白水平相比较差异无统计学意义(P>0.05)。血尿酸正常组牛津分型主要见于M0E0S0T0C0(57.4%),血尿酸升高组牛津分型主要见于M1E0S1T0C0(48%)。血尿酸水平与肾小管间质损害有正相关性(P<0.05)。血尿酸水平在系膜细胞增殖(M)2个亚组组间比较差异无统计学意义(F=2.409,P>0.05),血尿酸水平在内皮细胞增殖(E)2个亚组组间比较差异无统计学意义(F=1.629,P>0.05)。血尿酸水平在肾小球节段性硬化/粘连(S)2个亚组组间比较差异无统计学意义(F=1.432,P>0.05),血尿酸水平在肾小管萎缩/肾间质纤维化(T)各亚组间比较差异有统计学意义(H=7.220,P<0.05)。结论IgA肾病患者血尿酸水平升高可能会加重其肾脏功能及病理损害,高尿酸血症是IgA肾病预后不良的主要因素之一,与IgA肾病病变的严重程度密切相关。

Objective To analyze the correlation between serum uric acid levels and the clinical and pathological progression of IgA nephropathy,so as to provide the theoretical basis for clinical treatment and improve the prognosis of IgA nephropathy.Methods The general conditions,clinical parameters and pathological data of 79 patients who diagnosed as primary IgA nephropathy by renal biopsy were retrospectively analyzed.According to the level of serum uric acid,the patients were divided into the elevated uric acid group and the normal uric acid group,then the general conditions,clinical indicators and pathological features between the two groups were analyzed.Results Compared with patients of the normal uric acid group,the creatinine was significantly increased in patients with elevated blood uric acid(P<0.05).there was no significant statistically difference in the 24-hour urine protein quantitation,hemoglobin and serum albumin levels between the two groups(P>0.05).The pathological data of the two groups showed that the Oxford classification of the normal group of blood uric acid was mainly found in M0E0S0T0C0(57.4%),the Oxford classification of the group with elevated blood uric acid was mainly found in M1E0S1T0C0(48%).There was a positive correlation between serum uric acid level and tubulointerstitial damage(P<0.05).The blood uric acid levels were not significantly different between the two subgroups of mesangial cell proliferation(M)(F=2.409,P>0.05).There was no significant difference in blood uric acid levels between the two subgroups of endothelial cell proliferation(E)(F=1.629,P>0.05).The blood uric acid levels in glomerular segmental sclerosis/adhesion(S)was no statistically significant difference between the two subgroups(F=1.432,P>0.05).The difference in blood uric acid levels between renal tubular atrophy/interstitial fibrosis(T)was statistically significant.(H=7.220,P<0.05).Conclusion The increase of blood uric acid levels in patients with IgA nephropathy may aggravate their renal function and pathological damage.Hyperuricemia is one of the main factors for the poor prognosis of IgA nephropathy,which is closely related to the severity of IgA nephropathy.