论文部分内容阅读
目的探讨高脂血症对轻中度蛋白尿IgA肾病患者临床及病理特征的影响。方法选取原发性IgA肾病中表现为轻中度蛋白尿的成人患者529例。根据血脂水平分为高脂血症组和血脂正常组,分析2组患者临床与病理差异。比较不同尿蛋白水平的患者高脂血症与临床和病理特征的关系。结果与血脂正常组相比,高脂血症组患者的体质量指数(BMI)、收缩压、舒张压、尿酸(UA)、24 h尿蛋白定量均显著升高,肾小管萎缩间质纤维化、肾间质炎性细胞浸润程度较重(P<0.05)。Pearson相关分析表明,高脂血症组总胆固醇(CHOL)与24 h尿蛋白定量、收缩压呈正相关,与血浆白蛋白(ALB)负相关;甘油三酯(TG)与24 h尿蛋白定量、BMI、估算肾小球滤过率(e GFR)呈正相关。高密度脂蛋白胆固醇(HDL)与BMI、ALB、UA、舒张压呈负相关。24 h尿蛋白定量在1~3.5 g的患者中,高脂血症组患者239例(76.6%),与血脂正常者相比,其BMI、收缩压、舒张压、UA、24 h尿蛋白定量均显著升高,系膜增殖、系膜细胞增生程度加重(P<0.05)。尿蛋白定量不足1 g的患者中,高脂血症患者132例(60.7%),与血脂正常者相比,前者BMI、UA均升高,吸烟、饮酒多见,间质纤维化程度较重(P<0.05)。结论高脂血症患者的BMI、血压、UA、24 h尿蛋白定量均显著升高,肾小管萎缩间质纤维化、肾间质炎性细胞浸润程度较重。24 h尿蛋白定量在1~3.5 g患者中,高脂血症的发生率高于尿蛋白不足1 g患者。
Objective To investigate the effect of hyperlipidemia on the clinical and pathological features of mild and moderate proteinuria in patients with IgA nephropathy. Methods 529 adult patients with mild to moderate proteinuria were selected from primary IgA nephropathy. Divided into hyperlipidemia group and normal lipid group according to the level of blood lipid, and analyzed the clinical and pathological differences between the two groups. The relationship between hyperlipidemia and clinical and pathological features in patients with different urinary protein levels was compared. Results The body mass index (BMI), systolic blood pressure, diastolic blood pressure, uric acid (UA), 24 h urinary protein in patients with hyperlipidemia were significantly higher than those in patients with normal lipids, and tubulointerstitial fibrosis , Interstitial inflammatory cell infiltration was more severe (P <0.05). Pearson correlation analysis showed that total cholesterol (CHOL) in hyperlipemia group was positively correlated with 24 h urinary protein and systolic blood pressure, and negatively correlated with serum albumin (ALB); triglyceride (TG) and 24 h urinary protein, BMI, estimated glomerular filtration rate (e GFR) was positively correlated. High-density lipoprotein cholesterol (HDL) was negatively correlated with BMI, ALB, UA and diastolic blood pressure. 239 patients (76.6%) with 24 h urinary protein in 1 ~ 3.5 g of patients with hyperlipidemia had higher BMI, systolic blood pressure, diastolic blood pressure, UA, 24 h urinary protein Were significantly increased, mesangial proliferation, mesangial cell proliferation increased (P <0.05). 132 patients (60.7%) with hyperlipidemia were the patients with urinary protein less than 1 g. Compared with those with normal blood lipids, the former had higher BMI and UA, smoking, more alcohol, and more severe interstitial fibrosis (P <0.05). Conclusion The BMI, blood pressure, UA and 24 h urinary protein in patients with hyperlipidemia were significantly increased, interstitial tubulointerstitial fibrosis and severe interstitial infiltration of inflammatory cells were found. 24 h urinary protein in patients with 1 ~ 3.5 g, the incidence of hyperlipidemia than urinary protein less than 1 g patients.