不同体重指数原发性膜性肾病患者的影响因素分析

Influencing factors of primary membranous nephropathy in patients with different body mass index

目的探讨不同体重指数(BMI)原发性膜性肾病(PMN)患者的影响因素。方法回顾性分析2012年4月至2021年12月萍乡市人民医院行肾穿刺活检术明确诊断为PMN的191例患者的临床资料,根据BMI将患者分为A组(BMI≤24 kg/m2)111例和B组(BMI>24 kg/m2)80例,比较两组患者年龄、性别、收缩压(SBP)、舒张压(DBP)、肌酐清除率(Ccr)、肾小管间质慢性病变分级程度、24 h蛋白尿定量、肌酐(Cr)、尿素氮(BUN)、甘油三酯(TG)、胆固醇(CHO)、血糖(BS)和血尿酸(UA),影响因素采用logistic回归分析。结果A组SBP、DBP低于B组,差异有统计学意义(P<0.05);两组患者年龄、性别、Ccr、肾小管间质慢性病变分级比较,差异无统计学意义(P>0.05);A组BUN、TG、CHO、UA低于B组,差异有统计学意义(P<0.05);两组患者24 h蛋白尿定量、Cr、BS比较,差异无统计学意义(P>0.05);多因素logistic分析结果显示,SBP、DBP与BUN(OR=3.117、3.053、2.992,95%CI:1.095~8.879、1.110~8.393、1.286~6.964,P=0.034、0.031、0.011)是PMN患者的危险因素(P<0.05)。结论不同BMI的PMN患者临床和病理指标存在差异,血压及BUN水平是高BMIPMN患者的影响因素。

Objective To investigate the influencing factors of primary membranous nephropathy(PMN)in patients with different body mass index(BMI).Methods The clinical data of 191 patients diagnosed with PMN by renal biopsy in Pingxiang People's Hospital from April 2012 to December 2021 were retrospectively analyzed.The patients were divided into group A(BMI≤24 kg/m2,111 cases)and group B(BMI>24 kg/m2,80 cases)according to BMI.Age,gender,systolic blood pressure(SBP),diastolic blood pressure(DBP),creatinine clearance rate(Ccr),the grade of chronic renal tubulointerstitial lesions,24-hour urine protein,creatinine(Cr),blood urea nitrogen(BUN),triglyceride(TG),cholesterol(CHO),blood sugar(BS)and blood uric acid(UA)were compared between the two groups.Logistic regression analysis was performed to screen the influencing factors.Results The SBP and DBP of group A were lower than those of group B,and the differences were statistically significant(P<0.05).Age,gender,Ccr and the grade of chronic renal tubulointerstitial lesions showed no statistically significant differences between the two groups(P>0.05).BUN,TG,CHO and UA in group A were lower than those in group B,and the differences were statistically significant(P<0.05),but there were no statistically significant differences in 24-hour urine protein,Cr or BS between the two groups(P>0.05).Multivariate logistic analysis results showed that SBP,DBP and BUN(OR=3.117,3.053,2.992,95%CI:1.095-8.879,1.110-8.393,1.286-6.964,P=0.034,0.031,0.011)were risk factors of PMN(P<0.05).Conclusion The clinical and pathological indicators are different in PMN patients with different BMI.Blood pressure and BUN level are influencing factors of PMN in patients with high BMI.