刘睿, 关雪, 陈光磊, 张晓旭, 汤海莲, 李长春, 马路. 成人IgA肾病伴血脂异常临床及病理分析[J]. 临床肾脏病杂志, 2019, 19(3): 187-190. DOI: 10.3969/j.issn.1671-2390.2019.03.007
    引用本文: 刘睿, 关雪, 陈光磊, 张晓旭, 汤海莲, 李长春, 马路. 成人IgA肾病伴血脂异常临床及病理分析[J]. 临床肾脏病杂志, 2019, 19(3): 187-190. DOI: 10.3969/j.issn.1671-2390.2019.03.007
    shu
    LIU Rui, GUAN Xue, CHEN Guang-lei, ZHANG Xiao-xu, TANG Hai-lian, LI Chang-chun, MA Lu. Clinical features and pathological changes in adult IgA nephropathy with dyslipidemia[J]. Journal of Clinical Nephrology, 2019, 19(3): 187-190. DOI: 10.3969/j.issn.1671-2390.2019.03.007
    Citation: LIU Rui, GUAN Xue, CHEN Guang-lei, ZHANG Xiao-xu, TANG Hai-lian, LI Chang-chun, MA Lu. Clinical features and pathological changes in adult IgA nephropathy with dyslipidemia[J]. Journal of Clinical Nephrology, 2019, 19(3): 187-190. DOI: 10.3969/j.issn.1671-2390.2019.03.007
    shu

    成人IgA肾病伴血脂异常临床及病理分析

    Clinical features and pathological changes in adult IgA nephropathy with dyslipidemia

      摘要
    • 摘要: 目的 探讨成人IgA肾病（IgAN）伴血脂异常的临床及病理特点差异，以指导临床实践。方法 回顾性分析2010年1月1日至2017年6月30日在北戴河康复疗养中心住院并行肾穿剌病理检查的850例成人IgAN病例，分别比较伴不同血脂异常类型的IgAN的临床及病理特征。结果 ①与血脂正常组比较，血脂异常各组年龄偏大，且三酰甘油（TG）升高组、总胆固醇（TC）升高组、低密度脂蛋白胆固醇（LDL-C）升高组与血脂正常组年龄差异有统计学意义；血脂异常各组血白蛋白（Alb）降低、血肌酐（Scr）及血尿素（UREA）升高，且均具有统计学意义；血脂异常各组24 h尿蛋白定量（U-TP24 h）升高，且TG升高组、TC升高组、LDL-C升高组与血脂正常组差异有统计学意义；②与血脂正常组比较，血脂异常组血压偏高，且TG升高组（Hc=23.5964，P<0.01）、TC升高组（Hc=27.7997，P<0.01）、LDL-C升高组（Hc=19.507，P<0.01）差异有统计学意义；③与血脂正常组比较，血脂异常组病理分级较重，且TG升高组（Hc=19.5893，P<0.01）、TC升高组（Hc=23.4713，P<0.01）、LDL-C升高组（Hc=5.4276，P=0.0198）差异有统计学意义。结论 血脂异常（包括TG升高、TC升高、HDL-C降低、LDL-C升高）是IgAN进展的危险因素，血脂异常不同类型对于IgAN影响虽略有差异；但对于血脂异常患者，均应积极进行调脂治疗，以延缓IgAN进展。

       

      Abstract: Objective To investigate difference between clinical and pathological features of adult IgA nephropathy (IgAN) with dyslipidemia,in order to instruct clinical practices.Methods A retrospective analysis was performed in 850 cases of patients with adult IgA nephropathy hospitalized and examined pathologically by means of renal puncture in Beidaihe Rehabilitation and Recuperation Center from 1 Jan.2010 to 30 Jun.2017.The study included 850 adult IgAN patients who were in the hospital from January 2010 to June 2017.The Clinical features and pathological changes of IgAN with different types of dyslipidemia were compared respectively.Results ① Compared to the normal blood lipid group,the IgAN patients in the groups with abnormal blood lipid were older;and the age differences between the triglyceride (TG) raising group,total cholesterol (TC) raising group or low density lipoprotein cholesterol (LDL-C) raising group and the normal blood lipid group were of statistical significance.In the abnormal blood lipid groups,blood albumin (Alb) decreased,and serum creatinine (SC) and blood Urea (UREA) increased,all with statistical significance.Furthermore,in the abnormal blood lipid groups,24 h urinary protein (U-TP24 h) increased,and the differences between the TG raising group,TC raising group or LDL-C raising group and the normal blood lipid group were of statistical significance.② Compared to the normal lipid group,blood pressures in the abnormal lipid groups were higher,and the differences between the TG raising group (Hc=23.5964,P<0.01),TC raising group (Hc=27.7997,P<0.01) or LDL-C raising group and the normal lipid group were of statistical significance.③ Compared to the normal lipid group,pathological grading showed more severe,and the differences between the TG raising group (Hc=19.5893,P<0.01),TC raising group (Hc=23.4713,P<0.01) or LDL-C raising group (Hc=5.4276,P=0.0198) and the normal blood lipid group were of statistical significance.Conclusions Dyslipidemia (including TG raise,RC raise,HDL-C decrease and LDL-C raise) is a risk factor for progression of IgAN.Effects of various types of dyslipidemia on IgAN have slight difference,but patients with dyslipidemia all should be treated positively with lipid adjustment methods,so as to delay progression of IgAN.

       

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