554例IgA肾病患者临床特征分析

Analysis of clinical characteristics of 554 patients with IgA nephropathy

目的探讨IgA肾病的特征及不同肾功能分期的临床特点。方法选取经临床和肾脏病理明确诊断为IgA肾病的患者,收集所有病例的一般情况及临床资料,分析不同年龄层IgA肾病患者临床表现分布、不同慢性肾脏病(CKD)分期患者的临床特点,以及进展性肾功能不全IgA肾病患者的血清肌酐水平与临床各指标的相关性。结果共纳入554例IgA肾病患者,临床表现以蛋白尿或合并血尿最常见,其次是进展性慢性肾功能不全。单纯血尿主要集中在14-40岁,中青年IgA肾病患者最常见的临床表现是蛋白尿或合并血尿,50岁以上IgA肾病患者以进展性慢性肾功能不全最为常见。CKD4期前的分期越高,尿蛋白定量越高(P均<0.05),随着CKD分期升高,IgA肾病患者的血尿酸、CRP水平升高,血红蛋白、白蛋白降低(P均<0.05),且血清肌酐与血红蛋白及白蛋白呈负相关(P均<0.05),与年龄、尿蛋白定量、甘油三酯、血尿酸、CRP呈正相关(P均<0.05)。结论IgA肾病患者的尿蛋白、CRP、甘油三酯和血尿酸水平越高,可能提示其肾功能越差。

Objective To investigate the characteristics of IgA nephropathy and clinical characteristics of different stages of renal function.Methods A total of 554 patients with clinical biopsy-proven IgA nephropathy were included in this study.Baseline clinical and laboratory data were collected.The composition ratio of clinical manifestations in patients with IgA nephropathy of different ages was analyzed,clinical characteristics of patients with different CKD stages were assessed,and the correlation between serum creatinine levels and clinical indicators in IgA nephropathy patients complicated with progressive renal failure was evaluated.Results Proteinuria or hematuria were the most common clinical manifestations of patients with IgA nephropathy,followed by progressive chronic renal failure.Hematuria mainly occurred in patients aged 14-40 years.The most prevalent clinical manifestations of the young and middle-aged patients were proteinuria or proteinuria complicated with hematuria,and progressive chronic renal failure was the most common among those aged over 50 years old.The higher the pre-CKD4 stage,the higher the proteinuria level(all P<0.05).With the increasing CKD stage,the uric acid and CRP levels were significantly elevated,whereas the hemoglobin and albumin levels were remarkably declined(all P<0.05).Serum creatinine was positively correlated with age,proteinuria,triglycerides,serum uric acid,and CRP(all P<0.05).Conclusion High proteinuria,CRP,triglycerides and serum uric acid levels might indicate poor renal function in patients with IgA nephropathy.