IgA肾病患者系膜区补体C3沉积强度与病情程度的关系

The relationship between the intensity of complement C3 deposition in the mesangial region and the severity of illness in patients with IgA nephropathy

目的探究IgA肾病患者系膜区补体C3沉积强度与病情程度的关系。方法选取323例经皮肾活检穿刺术确诊的IgA肾病患者为研究对象,根据肾小球系膜区是否存在C3沉积、C3沉积强度分为C3阴性组、C3阳性组、C3强阳性组,比较三组血肌酐(Scr)、肾小球滤过率(eGFR)、血清C3、血清IgA、24 h尿蛋白定量水平及Lee病理分级差异。结果323例IgA肾病患者中,C3阴性组、C3阳性组、C3强阳性组分别为29、246、48例。三组血清IgA、24 h尿蛋白定量水平比较均无显著差异(P>0.05);Scr比较,C3阳性组、C3强阳性组均高于C3阴性组(P<0.01),C3强阳性组高于C3阳性组(P<0.01);eGFR比较,C3阳性组、C3强阳性组均低于C3阴性组(P<0.01),C3阳性组、C3强阳性组比较无显著差异(P>0.05);血C3比较,C3阳性组、C3强阳性组均低于C3阴性组(P<0.01),且C3强阳性组低于C3阳性组(P<0.05);C3阴性组、C3阳性组、C3强阳性组三组间Lee病理分级比较有显著差异(P<0.01)。结论IgA肾病患者系膜区补体C3沉积强度越强,肾脏病理损伤越严重,患者病情越重。

Objective To explore the relationship between the intensity of complement C3 deposition in the mesangial region and the severity of illness in patients with IgA nephropathy.Methods Three hundred and twenty-three patients with IgA nephropathy diagnosed by percutaneous renal biopsy and puncture were selected as the research objects.According to the presence of C3 deposition in the glomerular mesangial area and the intensity of C3 deposition,they were divided into C3 negative group,C3 positive group,and C3 strong positive group.There were twenty-nine,two hundred and forty-six,and forty eight cases in the C3 negative group,C3 positive group,and C3 strong positive group,respectively.Results There was no significant difference between the three groups of serum IgA and 24 h urine protein quantitative levels(P>0.05);Scr comparison,C3 positive group and C3 strong positive group are higher than C3 negative group(P<0.01),C3 strong positive group is higher than C3 positive group(P<0.01);eGFR comparison,C3 positive group and C3 strong positive group are both Lower than the C3 negative group(P<0.01),and there was no significant difference between C3 positive group and C3 strong positive group(P>0.05);Blood C3 comparison,C3 positive group,C3 strong positive group are lower than C3 negative group(P<0.01),and C3 strong positive group is lower than C3 positive group(P<0.05).There were significant differences in Lee pathological grading among the C3 negative group,C3 positive group,and C3 strong positive group(P<0.01).Conclusion The stronger the intensity of complement C3 deposition in the mesangial area of patients with IgA nephropathy,the more severe the kidney pathological damage,and the more severe the patient’s condition.