IgA肾病患者高尿酸血症状况及其危险因素研究

The status of hyperuricemia in patients with IgA nephropathy and risk factors

目的:探讨IgA肾病合并高尿酸血症患者的临床及病理特征,分析影响高尿酸血症发生的相关因素。方法:收治经肾穿刺活检病理确诊为IgA肾病的患者109例,根据患者是否合并有高尿酸血症,分为高尿酸血症组41例和正常尿酸血症组68例,分析两组的临床、病理特征及患者高尿酸血症发生的危险因素。结果:合并有高尿酸血症患者的比例37.61%(41/109);高尿酸血症组的患者年龄较大,男性比例及高血压患者比例高,体重指数、血脂及24小时尿蛋白定量较高,血白蛋白较低,肾功能差,两组临床资料比较差异有统计学意义(P<0.05);高尿酸血症组球性硬化、节段性硬化、新月体形成、小管萎缩、间质炎性浸润及间质纤维化等的比例均要高于正常尿酸组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,男性患者、胆固醇和甘油三酯升高均与IgA肾病患者高尿酸血症的发生相关,OR值分别为2.942、2.012和2.301(P<0.05)。结论:对高尿酸血症的相关危险因素应加以重视,对存在相关危险因素的患者进行及时有效地干预治疗,可以延缓疾病的进展,改善预后。

Objective:To investigate the Clinical and pathological features of IgA nephropathy patients with hyperuricemia,and to analyze related factors of hyperuricemia occurred.Methods:We selected 109 cases of IgA nephropathy patients diagnosed by renal biopsy in 2004 June to 2013 June.These patients were divided into hyperuricemia group in 41 cases and normal uric acid group in 68 cases according to whether the patients with hyperuricemia.We analyzed the clinical,pathological features and risk factors of hyperuricemia in patients with two groups of patients.Results:There was a ratio of 37.61%(41/109)patients with hyperuricemia. The age of patients with hyperuricemia group was larger.Hyperuricemia group had more men and hypertensive patients.Body mass index,blood lipid and 24 hour urinary protein quantitative of hyperuricemia group were higher.Albumin of hyperuricemia group was low.Renal function of hyperuricemia group was poor.There were statistically significant differences between the two groups(P<0.05).The ratio of Glomerulosclerosis,segmental glomerulosclerosis,crescent formation of hyperuricemia patients, tubular atrophy,interstitial inflammatory cell infiltration and interstitial fibrosis of hyperuricemia group was higher than that of normal uric acid group,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed:male patients,elevated cholesterol and triglyceride were associated with the occurrence of hyperuricemia in patients with IgA nephropathy,the OR values were respectively 2.942,2.012 and 2.301(P<0.05).Conclusion:The related risk factors of hyperuricemia should be pay attention.Time and effective intervention and treatment of patients with risk factors may delay progression of disease and improve the prognosis.