IgA肾病风湿证特性临床病理指标探究

Exploring on Characteristic Clinical and Pathological Indexes of IgA Nephropathy Patients with Wind-Dampness Syndrome

目的:筛选与IgA肾病风湿证相关的临床病理指标,探讨IgA肾病风湿证的病变特性。方法:选择2015年1月—2019年12月在本院肾内科行肾穿诊断为原发性IgA肾病患者,辨证为风湿证的患者(275例)纳入风湿组;非风湿证的患者(268例)纳入非风湿组。收集病例资料并记录两组患者的牛津分型结果,光镜下观察系膜细胞增生程度、内皮细胞增生程度及各类新月体个数,并进行24 h尿蛋白定量检测和尿红细胞计数。结果:与非风湿组患者比较,风湿组患者牛津分型E、C得分更高,光镜可见系膜细胞、内皮细胞增生更明显,细胞性新月体、细胞纤维性新月体形成更多,尿红细胞计数更多,尿蛋白定量高(P<0.05)。结论:IgA肾病风湿证患者病变活动性更强,临床上除症状外、结合活动性指标有利于正确判断疾病阶段,及时采取积极治疗方案,从而改善预后。

Objective:To explore the pathological characteristics of wind-dampness syndrome of IgA nephropathy,through screening out the clinical and pathological indexes related to Wind-dampness syndrome of IgA nephropathy.Methods:Selected patients who were diagnosed as primary IgA nephropathy by nephrology in the nephrology department of our hospital from January 2015 to December 2019 and were diagnosed as Wind-dampness syndrome(275 cases)were included in the wind-dampness group;Patients with non-wind-dampness syndrome(268 cases)were included in the non-wind-dampness group.Collect case data and record the Oxford classification results of the two groups of patients,the degree of mesangial cell proliferation,the degree of endothelial cell proliferation and the number of various crescents were observed under the light microscope,as well as the 24-hour urine protein quantification and urine red blood cell count were determined in the laboratory.Results:To compare with non-wind-dampness syndrome,the scores of Oxford classification E and C in the wind-dampness group were higher,proliferation of mesangial cells and endothelial cell were more obvious,cellular crescents and cell fibrous crescents formed more,and 24-hour urine protein quantification and urine red blood cell count were more significant(P<0.05).Conclusion:The activity of pathological changes in IgA nephropathy patient with wind-dampness syndrome was more significant,to correctly judge the stage of the disease and adopt active treatment plans in time to improve the prognosis according to active indexes is helpful for clinic.