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[1]王心,陈铖.伴高尿酸血症的原发性IgA肾病的临床及病理特征分析[J].医学研究与战创伤救治(原医学研究生学报),2017,19(06):600-603.[doi:10.3969/j.issn.1672-271X.2017.06.010]
　WANG Xin,CHEN Cheng.The clinical and pathological features of primary IgA nephropathy with hyperuricemia[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(06):600-603.[doi:10.3969/j.issn.1672-271X.2017.06.010]
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伴高尿酸血症的原发性IgA肾病的临床及病理特征分析()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第19卷
期数:
2017年06期
页码:
600-603
栏目:
出版日期:
2017-11-23

文章信息/Info

Title:
The clinical and pathological features of primary IgA nephropathy with hyperuricemia
作者:
王心; 陈铖
作者单位：430060武汉，武汉大学人民医院肾内科
Author(s):
WANG Xin; CHEN Cheng
(Department of Nephrology，Renmin Hospital of Wuhan University，Wuhan 430060，Hubei，China)
关键词:
IgA肾病; 高尿酸血症; 临床; 病理
Keywords:
IgA nephropathy; Hyperuricemia; Clinical; Pathological
分类号:
R586
DOI:
10.3969/j.issn.1672-271X.2017.06.010
文献标志码:
A
摘要:
目的分析伴高尿酸血症的原发性IgA肾病（IgAN）的临床与病理特点，为诊治提供依据。方法回顾性分析武汉大学人民医院2015年1月至2017年3月在肾内科经肾穿刺活检确诊为原发性IgAN的288例患者的临床及病理活检结果，按血尿酸水平分为高尿酸组和正常尿酸组。结果288例患者中，高尿酸患病率为43.06%（124例）；高尿酸组患者的收缩压、舒张压、24小时尿蛋白定量、血尿素氮、血肌酐、三酰甘油、低密度脂蛋白水平显著高于正常尿酸组（P<0.05）；2组患者的年龄、性别、高密度脂蛋白、血浆总蛋白、血浆白蛋白比较差异无统计学意义（P>0.05）。2组患者慢性肾脏病分期差异有统计学意义（P<0.05）。牛津分型结果表明，2组患者的在系膜增生（M）、肾小管萎缩或间质纤维化（T）存在统计学差异（P<0.05），而内皮细胞增生（E）、节段性硬化或粘连（S）方面差异无统计学意义（P>0.05）。结论伴高尿酸血症的IgAN比正常血尿酸的IgAN患者的临床及病理病变更严重，应予以重视并给与有效及及时的治疗。
Abstract:
ObjectiveTo analyze the clinical and pathological characteristics of primary IgA nephropathy (IgAN) with hyperuricemia and provide a basis for diagnosis and treatment for this disease.MethodsThe clinical and pathological biopsy results of 288 patients with IgAN were collected in Renmin Hospital of Wuhan University from January 2015 to March 2017. The patients were divided into two groups by the level of uricemia: hyperuricemia and normal uric acid. The clinical and pathological dates of two groups were retrospectively analyzed.ResultsThe prevalence of high uric acid was 43.06% in 288 patients. The systolic blood pressure, diastolic blood pressure, 24-hour urine protein quantification, blood urea nitrogen, serum creatinine, triglyceride and low density lipoprotein were significantly higher in high uric acid group (P<0.05). There was no significant difference in age, sex, high density lipoprotein, plasma total protein and plasma albumin (P>0.05). There were significant differences in staging of chronic kidney disease (P<0.05). Oxford typing results showed that there were statistically significant differences in mesangial hyperplasia, tubular atrophy or interstitial fibrosis between the two groups (P<0.05), and there was no difference in endothelial cell proliferation, segmental sclerosis or adhesions (P>0.05).ConclusionClinical and pathological lesions in IgAN patients with hyperuricemia are more serious than that with normal uric acid. More attention should be paid. Effective and timely treatments are needed

参考文献/References:

[1]Wyatt RJ, Julian BA. IgA Nephropathy[J]. New Engl J Med,2013,368(25):2402-2414.
[2]郭宗运,王营营,李慧,等.表现为微量白蛋白尿IgA肾病预后的危险因素分析[J].中国医师杂志,2015,17(11):1694-1697.
[3]陈香美,谢院生. 重视延缓IgA肾病进展的基础和临床研究[J].中华肾脏病杂志,2004,20(4):1-3.
[4]D’Amico G. Natural history of idiopathic IgA nephropathy and factors predictive of disease outcome[J]. Semin Nephrol,2004,24(3):179-196.
[5]Moriyama T, Itabashi M, Takei T, et al. High uric acid level is a risk factor for progression of IgA nephropathy with chronic kidney disease stage G3a[J]. J Nephrol，2015,28(4):451-456.
[6]Moriyama T, Tanaka K, Iwasaki C, et al.Prognosis in IgA nephropathy: 30-year analysis of 1,012 patients at a single center in Japan[J]. PLoS One,2014,9(e917563)：doi: 10.1371/journal.pone.0091756. eCollection 2014.
[7]Le W, Liang S, Hu Y, et al. Long-term renal survival and related risk factors in patients with IgA nephropathy: results from a cohort of 1155 cases in a Chinese adult population[J]. Nephrol Dial Transplant,2012,27(4):1479-1485.
[8]陈颖越,金星,丁波,等. 2型糖尿病患者尿酸与大血管病变的相关性分析[J].医学研究生学报,2014,27(2):221-222.
[9]矫树华,刘鹏亮,温艳惠. 脂肪肝与血脂、血糖、血尿酸及血清铁蛋白的相关性分析[J].东南国防医药,2015,17(3):275-277.
[10]陈涛,李卫,王杨,等.高尿酸血症的患病情况及相关因素分析[J].中华临床医师杂志(电子版),2012,6(13):3526-3529.
[11]蔡伟程,韩蜀莲,郭晓丹,等. IgA肾病合并高尿酸血症患者的临床病理分析[J].临床肾脏病杂志,2016,16(3):152-156.
[12]田耘,卓莉,李文歌,等. 149例IgA肾病合并高尿酸血症的临床和病理特点[J].北京医学,2012,34(4):257-259.
[13]樊星,韩鸿玲.IgA肾病伴高尿酸血症与肾脏病理改变的关系[J].实用医学杂志,2016,32(12):2014-2017.
[14]段晓雯,王利华,邵金金,等. IgA肾病患者合并高尿酸血症临床及病理特征分析[J].中华肾病研究电子杂志,2016,5(2):70-74.
[15]Baradaran A. Renal vascular lesions in IgA nephropathy[J]. J Renal Inj Prev,2013,2(2):37-38.
[16]Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial[J]. JAMA,2008,300(8):924-932.
[17]Kanji T, Gandhi M, Clase CM, et al. Urate lowering therapy to improve renal outcomes in patients with chronic kidney disease: systematic review and meta-analysis[J]. BMC Nephrol,2015,16(58)：doi: 10.1186/s12882-015-0047-z.
[18]师素芳,张宏.对于IgA肾病牛津病理分型验证现状的分析[J].中华肾脏病杂志,2012,28(3):167-169.
[19]Coppo R, Troyanov S, Bellur S, et al. Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments[J]. Kidney Int,2014,86(4):828-836.
[20]李卅立. IgA肾病牛津分型与临床指标的相关危险因素分析[D].中国医科大学,2013.
[21]Zhou J, Chen Y, Liu Y, et al. Plasma uric acid level indicates tubular interstitial leisions at early stage of IgA nephropathy[J]. BMC Nephrol,2014,15:11. doi: 10.1186/1471-2369-15-11.
[22]Mulay SR, Evan A, Anders H. Molecular mechanisms of crystal-related kidney inflammation and injury. Implications for cholesterol embolism, crystalline nephropathies and kidney stone disease[J]. Nephrol Dial Transpl,2014,29(3):507-514.
[23]Mende C. Management of chronic kidney disease: the relationship between serum uric acid and development of nephropathy[J]. Adv Ther,2015,32(12):1177-1191.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2017-11-20