基于209例IgA肾病远期预后的中西医危险因素的历史队列研究

Historical Cohort Study of Long-term Prognostic Risk Factors in 209 Cases of IgA Nephropathy

目的:采取历史队列研究中西医相关的指标对于IgA的预后的独立危险因素。方法:筛选出陕西省中医医院经过肾穿刺活检的IgAN患者209例,收集相关基本信息、实验室生化指标、病理指标、中医证候,采取复合终点为作为结局指标。通过SPSS26.0软件进行Cox回归生存分析,第一步Cox单因素分析筛选危险因素指标,再通过Cox多因素分析得出影响肾功能进展的独立危险因素。根据相关指标制作Kaplan-meier生存曲线图。结果:Cox单因素分析结果显示肾小球滤过率、尿蛋白定量、血肌酐、血尿酸、血尿素氮、血钾、血氯、血磷、血三酰甘油、高密度脂蛋白、牛津分型S评分、牛津分型T评分、中医本证脾肾阳虚、肺脾气虚,兼证水湿、血瘀、浊毒差异均有统计学意义(P<0.05),Cox多因素分析表明尿蛋白定量、三酰甘油、血瘀、浊毒、牛津分型T评分差异具有统计学意义(P<0.05)。结论:尿蛋白定量、三酰甘油、血瘀、浊毒、新牛津分型T评分是影响IgAN远期预后的独立危险因素。

Objective:To investigate the independent risk factors for the prognosis of IgA Nephropathy by using a historical cohort.Methods:A total of 209 IgAN patients who underwent renal biopsy in Shaanxi Hospital of Traditional Chinese Medicine were selected,and the relevant basic information,laboratory biochemical indicators,pathological indicators and TCM syndromes were collected,and the composite end point was taken as the outcome index.SPSS 26.0 software was used for Cox regression survival analysis.The first step was Cox univariate analysis to screen risk factors,and then Cox multivariate analysis was used to obtain independent risk factors affecting renal function progression.Kaplan-meier survival curve was made according to relevant indicators.Results:Cox univariate analysis results show that the glomerular filtration rate,urine protein quantitative,serum creatinine,blood uric acid,blood urea nitrogen,blood potassium,blood chlorine,blood phosphorus,blood triglycerides,High-density lipoprotein,Oxford type S score,Oxford type T score.Cox multivariate analysis showed that urinary protein quantification,triglyceride,blood stasis,turbidities and Oxford type T score.Had statistical significance(P<0.05).Conclusion:Urinary protein level,triglyceride,blood stasis,turbidity toxicity and Oxford T score are independent risk factors affecting long-term prognosis of IgAN.