文章摘要
王 凉,张 裕,张志坚,刘 斌,孙铸兴.代谢综合征促进IgA肾病进展的作用分析[J].南京医科大学学报,2013,(5):651~654
代谢综合征促进IgA肾病进展的作用分析
Effect of metabolic syndrome on the progression of IgA nephropathy
投稿时间:2012-11-07  
DOI:10.7655/NYDXBNS20130517
中文关键词: IgA肾病  代谢综合征  危险因素  肾脏病理  牛津分型
英文关键词: IgA nephropathy  metabolic syndrome  risk factor  renal pathology  Oxford classification
基金项目:
作者单位
王 凉 南京医科大学附属无锡市人民医院肾内科,江苏 无锡 214023 
张 裕 南京医科大学附属无锡市人民医院肾内科,江苏 无锡 214023 
张志坚 南京医科大学附属无锡市人民医院肾内科,江苏 无锡 214023 
刘 斌 南京医科大学附属无锡市人民医院肾内科,江苏 无锡 214023 
孙铸兴 南京医科大学附属无锡市人民医院肾内科,江苏 无锡 214023 
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中文摘要:
      目的:比较原发性IgA肾病(IgA nephropathy,IgAN)合并代谢综合征(metabolic syndrome,MS)与未合并MS患者的临床及病理表现,分析MS对IgAN的影响,从而为IgAN合并MS患者治疗方案的选择提供依据。方法:选取2006年1月~2012年6月在南京医科大学附属无锡市人民医院行肾穿刺病理诊断为IgAN的病例453例,其中IgAN-MS组87例,IgAN-非MS组366例。检测两组患者的肾功能?尿蛋白及各代谢指标,分析各代谢指标与肾功能及尿蛋白的关系,并根据不同病理诊断标准对病理结果进行比较。结果:IgAN-MS组的尿蛋白定量?血清肌酐均显著高于IgAN-非MS组(P < 0.05);IgAN-MS组的病理改变显著重于IgAN-非MS组(P < 0.05)。Pearson相关性分析显示肾小球滤过率与24 h尿蛋白?平均动脉压?年龄?体质指数?甘油三酯呈负相关,24 h尿蛋白与空腹血糖?体质指数?血清白蛋白?甘油三酯?低密度脂蛋白胆固醇?尿酸呈正相关。Spearman相关分析显示MS与Lee氏分级及牛津分型的系膜细胞增生?毛细血管内增生?节段性肾小球硬化各项损伤评分均呈正相关。结论:MS是IgAN进展的危险因素,代谢指标异常可加重IgAN的肾损害。
英文摘要:
      Objective:To compare clinical and pathologic manifestation between patients with idiopathic IgA nephropathy (IgAN) accompanied by metabolic syndrome (IgAN-MS) and IgAN-non-MS and to investigate the impact of MS on IgAN. Methods:A total of 453 patients with renal biopsy-proven idiopathic IgAN from Jan. 2006 to Jun. 2012 in Wuxi People’s Hospital were enrolled in this study. Then 87 patients were assigned to the IgAN-MS group and other 366 patients were assigned to the IgAN-non-MS group. A comparative analysis of clinical and pathological data between these two groups was performed. Results:Urine protein, serum creatinine in the IgAN-MS group were significantly higher than those in the IgAN-non-MS group(P < 0.05). Pathological changes in the IgAN-MS group were significantly more severe than those in the IgAN-non-MS group(P < 0.05). eGFR was negativly correlated with urine protein of 24 hours, mean arterial pressure,age, body mass index, and serum triglyceride, while urine protein of 24 hours was positive correlated with fasting blood-glucose, body mass index, serum triglyceride and albumin,LDL-C and urine acid by Pearson correlation analysis. There were positive relationship between MS and Lee’s classification(or damage index in Oxford classification). Conclusion:MS may be an important risk factor for IgAN progression. The factors of MS could aggravate renal damage.
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