摘要
目的:探讨足突融合与IgAN患者临床、病理变化及其严重程度的相关性,为IgAN患者的治疗和预后提供指导。方法:2017年9月~2020年2月黄山市人民医院收治的并在我院行肾组织活检病理明确诊断为原发性IgAN的患者57例,根据患者肾穿刺活检电镜下足细胞是否融合,分成足细胞无融合组与足细胞融合组,收集患者临床生化指标包括活检前血肌酐,24小时尿蛋白定量,血红蛋白,血白蛋白;及肾活检病理资料包括牛津分型和Lee氏分级。通过多因素逐步线性回归分析足突融合与IgA肾病活动性或疾病进展的相关性。结果:足细胞无融合组与足细胞融合组之间的24小时尿蛋白定量有显著差异,血清肌酐、血红蛋白和血白蛋白均无差异。足突融合组和足突未融合组的牛津病理分型的比较,结果显示两组患者病理表现基本一致,差异无统计学意义。足突融合组和足突无融合组的Lee氏分级比较,差异无统计学意义。结论:足细胞无融合组与足细胞融合组之间的24小时尿蛋白定量有显著差异,其余生化及病理分型指标均无差异。提示足细胞损伤可能与IgA肾病的蛋白尿症状有关。
Objective To investigate the correlation between foot process fusion and clinical,pathological changes and severity of IgA nephropathy patients,so as to provide guidance for treatment and prognosis of IgA nephropathy patients.Methods From September 2017 to February 2020,57 patients with primary IgA nephropathy were admitted to Huangshan People’s Hospital.The patients were divided into podocyte unfusion group and podocyte fusion group according to whether the podocyte was fused under renal biopsy electron microscope.Clinical biochemical indicators were collected,including serum creatinine,24-hour urinary protein quantification,hemoglobin and hemoglobin before biopsy.And pathological data of renal biopsy included Oxford type and Lee’s grade.The association between foot process fusion and IgA nephropathy activity or disease progression was analyzed by multivariate stepwise linear regression.Results There was significant difference in 24-hour urinary protein quantification between podocyte unfusion group and podocyte fusion group,and no difference in serum creatinine,hemoglobin and serum albumin.Comparison of Oxford pathological typing between the foot process fusion group and the foot process unfusion group showed that the pathological manifestations of the two groups were basically the same,with no statistically significant difference.Comparison of Lee’s grades between the foot process fusion group and the foot process unfusion group showed no statistically significant difference.Conclusion There was significant difference in 24-hour urinary protein quantification between the podocyte unfusion group and podocyte fusion group,and no difference in other biochemical and pathological typing indexes.This suggests that podocyte injury may be associated with proteinuria symptoms in IgA nephropathy.
作者
刘栗丽
张赟辉
刘鲲
汪宏
Liu Li-li;Zhang Yun-hui;Liu Kun;Wang Hong(Department of Nephrology,Huangshan City People’s Hospital,Huangshan 245000,China)
出处
《湖南师范大学学报（医学版）》
2021年第4期224-226,共3页
Journal of Hunan Normal University(Medical Sciences)
作者简介
通讯作者:汪宏,E-mail:doctorwanghong@163.com
