| 摘要 目的 探讨高尿酸血症与IgA肾病临床病理的相关性。方法 选取2007年1月至2010年12月在吉林大学第一医院肾内科肾活检确诊为IgA肾病患者148例，根据血尿酸水平分为血尿酸正常组(107例)和血尿酸增高组(41例)，并对两组年龄、性别、高血压、病程、体重指数、生化指标及病理情况进行比较。结果 二组患者间性别、年龄等差异均无统计学意义(P>0.05)。血尿酸增高组患者高血压发病率、病程(月)、体重指数(kg/m2)、血尿素氮(mmol/L)、肌酐(μmol/L)、TG(mmol/L)及24 h尿蛋白定量(mg/24 h)分别为63.4%、18.90±10.12、22.81±3.60、8.93±4.28、155.96±107.72、2.11±1.06和4328.16±1434.25，而血尿酸正常组分别为38.3%、9.46±3.91、15.32±2.54、5.21±2.18、79.52±40.01、1.86±1.20和2885.10±1388.15，两组患者差异均有统计学意义(P值均<0.05)。Lee′s分级血尿酸增高组Ⅰ+Ⅱ级占12.2%、Ⅳ+Ⅴ级占39.0%，而血尿酸正常组Ⅰ+Ⅱ级占25.2%、Ⅳ+Ⅴ级占16.9%，两组患者差异均有统计学意义(P值均<0.05)。肾小管间质损害(TIL)分级血尿酸增高组以Ⅲ+Ⅳ级多见，占68.3%，而血尿酸正常组以Ⅱ级多见，占76.6%。肾小动脉病变分级血尿酸增高组以Ⅱ+Ⅲ级多见，占73.2%，而血尿酸正常组以0+Ⅰ级多见，占69.2%。结论 IgA肾病患者血尿酸水平与24 h尿蛋白定量、血压、肾功能损害相关，血尿酸升高者Lee′s分级、TIL分级及肾小动脉病变分级较差。 |
| 关键词：
尿酸
肾小球肾炎, IgA
临床病理学
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| Abstract：
Objective To analyze the correlation between the level of serum uric acid and the clinical and pathological features of IgA nephropathy. Methods Totally 148 patients diagnosed as IgA nephropathy by renal biopsy in our hospital from January 2007 to December 2010 were divided into hyperuricaemic group (41 cases) and non-hyperuricaemic group (107 cases) according to the level of serum uric acid. The clinical parameters and renal pathology grade were compared. Results There were significant differences between hyperuricaemic group and non-hyperuricaemic group in the incidences of hypertension (63.4% vs 38.3%), disease duration ［(18.90±10.12) months vs (9.46±3.91) months］and body mass index ［(22.81±3.60) kg/m2 vs (15.32±2.54) kg/m2］(all P0.05). The blood urea nitrogen (BUN) ［(8.93±4.28) mmol/L vs (5.21±2.18) mmol/L］, creatinine (Cr) ［(155.96±107.72) μmol/L vs (79.52±40.01) μmol/L］, serum triglycerides ［(2.11±1.06)mmol/L vs (1.86±1.20) mmol/L］and 24-hour urine protein amount ［(4328.16±1434.25) mg/24 h vs (2885.10±1388.15) mg/24 h］were significantly different between the two groups (all P<0.05). The percentage of Lee′s grade Ⅰ+Ⅱ in hyperuricaemic group was 12.2%, and Ⅳ+Ⅴgrade was 39.0%, while percentage of Lee′s grade Ⅰ+Ⅱ in non-hyperuricaemic group was 25.2%, and Ⅳ+Ⅴgrade was 16.9%(P<0.05).Tubulointerstitial lesions (TIL) grade Ⅲ+Ⅳ was more in hyperuricaemic group, which was 68.3%, while TIL grade Ⅱ was more in non-hyperuricaemic group, which was 76.6%.Renal artery damage grade Ⅱ+Ⅲ was more in hyperuricaemic group, which was 73.2%, while renal artery damage grade 0+Ⅰwas more in non-hyperuricaemic group, which was 69.2%. Conclusion The level of serum uric acid was related with 24-hour urine protein amount, blood pressure and kidney function in IgA nephropathy, and Lee′s grade, TIL grade and renal artery damage grade were severe in hyperuricaemic group. |
| Keywords：
Uric acid,
Glomerulonephritis, IgA,
Pathology, clinical
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| 收稿日期: 2010-12-28;
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| 基金资助: 吉林省卫生厅科研基金资助项目（2009ZC041) |
| 通讯作者 王红月
Email: why-changchun@sina.com
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