摘要
目的探讨贫血与IgA肾病临床、牛津病理分型及肾脏预后的关系,明确贫血是否为IgA肾病进展的危险因素。方法选取2020年1月至2021年1月首次就诊山西医科大学第二医院并完善经皮肾穿刺活检术后诊断为IgA肾病病人为研究对象。据血红蛋白(Hb)情况将病人分为贫血组和Hb正常组。生存分析采用Kapian-Meier法。比较两组临床特征、牛津病理(M、S、E、T)分型及肾存活率的差异。通过二元logistic回归方法分析贫血的影响因素。结果贫血组血肌酐(Scr)[171.50(76.75,253.25)μmol/L比76.50(64,90.75)μmol/L]、24 h尿蛋白定量[2.49(1.24,4.07)g/d比1.55(0.92,2.79)g/d]、慢性肾脏病(CKD)分期较Hb正常组高,肾小球滤过率(eGFR)[36.50(21.75,96.25)mL·min^(-1)·(1.73 m^(2))^(-1)比103(89.75,119.25)mL·min^(-1)·(1.73 m^(2))-1]、血清白蛋白(Alb)[(31.90±6.95)g/L比(37.81±6.89)g/L]较Hb正常组低(P<0.05)。牛津病理(M、S、E、T)分型比较,贫血组E、T分型较Hb正常组高(P<0.05)。Kapian-Meier生存分析结果显示,贫血组肾存活率较HB正常组低(38.9%比75.0%,P<0.05)。回归分析结果显示牛津病理(T)分型是IgA肾病合并贫血的独立危险因素,eGFR和ALB是IgA肾病合并贫血的保护因素(P<0.05)。结论贫血是IgA肾病病人的常见并发症。在IgA肾病病人中,贫血与肾功能下降、肾脏不良预后及间质损伤之间有显著相关性。贫血可能为IgA肾病进展的独立危险因素。
Objective To explore the relationship between anemia and the clinical,Oxford pathological classification and renal prog-nosis of IgA nephropathy,and to determine whether anemia is a risk factor for the progression of IgA nephropathy.Methods From Jan-uary 2020 to January 2021,patients who first visitedthe Second Hospital of Shanxi Medical University and were diagnosed as IgA ne-phropathy after percutaneous renal biopsy were selected as the research subiects.According to hemoglobin(Hb)level,patients were di-vided into anemia group and Hbnormal group.Kapian-Meier method was used for survival analysis.The difference of clinical character-istics,Oxford pathology(M,S,E,T)classification and renal survival rate between the two groupswere compared.The influencing factors for anemia were analyzed by binary logistic regression.Results The serum creatinine(Scr)[171.50(76.75,253.25)μmol/L vs.76.50(64,90.75)μmol/L],24-hour urine protein level[2.49(1.24,4.07)g/d vs.1.55(0.92,2.79)g/d]and chronic kidney disease(CKD)stage in the anemia group were higher than those in the normal Hb group,while glomerular filtration rate(eGFR)[36.50(21.75,96.25)mL·min^(-1)·(1.73 m^(2))-1 vs.103(89.75,119.25)mL·min^(-1)·(1.73 m^(2))^(-1)],serum albumin(Alb)[(31.90±6.95)g/L vs.(37.81±6.89)g/L]were lower than those in the normal Hb group(P<0.05).The comparison of Oxford pathological(M,S,E,T)classification showed that the E and T classifi-cation of anemia groupwere higher than thosein the normal Hb group(P<0.05).Kapian-Meier survival analysis showed that the renal sur-vival rate in the anemia group was lower than that in the normal Hb group(38.9%vs.75.0%,P<0.05).The results of regression analysis showed that the Oxford Pathology(T)classification was an independent risk factor for IgA nephropathy with anemia,and eGFR and ALB were protective factors for IgA nephropathy with anemia(P<0.05).Conclusions Anemia is a common complication of IgA ne-phropathy.In patients with IgA nephropathy,anemia is significantly associated with decreased renal function,poor renal prognosis and interstitial damage.Anemia may be an independent risk factor for the progression of IgA nephropathy.
作者
吕彩凤
郭珲
LYU Caifeng;GUO Hui(Department of Nephrology,The Second Hospital of Shanxi MedicalUniversity,Taiyuan,Shanxi 030001,China)
出处
《安徽医药》
CAS
2024年第2期313-316,共4页
Anhui Medical and Pharmaceutical Journal
基金
山西省应用基础研究计划项目(201901D1113777)
山西省回国留学人员科研教研项目(2020-191)。
关键词
肾小球肾炎
IGA
贫血
肾脏病理
肾脏预后
Glomerulonephritis,IGA
Anemia
Renal pathology
Prognosis of kidney
