尿蛋白测定方法与IgA肾病进展的相关研究

    A study on correlation of measures of urinary protein and albumin with progression of IgA nephropathy

    • 摘要: 目的 探讨IgA肾病患者尿蛋白肌酐比、尿白蛋白肌酐比、24 h尿蛋白定量之间的关系,并分别评估三者和IgA肾病临床及病理的关系,从而预测IgA肾病的进展。方法 收集2017年5月至2018年4月在安徽医科大学第一附属医院行肾脏活检确诊为IgA肾病的患者资料,记录患者尿蛋白肌酐比、尿白蛋白肌酐比、24 h尿蛋白定量、肾小球滤过率、血压、牛津分型等指标,研究尿蛋白肌酐比、尿白蛋白肌酐比和24 h尿蛋白定量三者之间的关系,并探讨三者和血压、肾小球滤过率、牛津分型等之间的关系。结果 IgA肾病患者的尿蛋白肌酐比、尿白蛋白肌酐比、24 h尿蛋白定量三者存在密切相关性,其中尿蛋白肌酐比和尿白蛋白肌酐比具有最高的相关性(rs=0.929,P<0.01),尿蛋白肌酐比、尿白蛋白肌酐比、24 h尿蛋白定量均和肾小球滤过率、牛津分型T、C存在明显相关性(P<0.05)。而有无高血压,牛津分型M、E、S和以上三者之间的关系无统计学差异(P>0.05)。结论 IgA肾病患者的尿蛋白肌酐比、尿白蛋白肌酐比和24 h尿蛋白定量之间密切相关,三者和肾小球滤过率、牛津分型T、C均存在明显相关性。

       

      Abstract: Objective To explore the association between urine albumin-to-creatinine ratio (ACR), protein-to-creatinine ratio and 24-hour urine protein in patients with IgA nephropathy (IgAN), and to evaluate the association of these measurements with clinical and pathological findings of IgAN, thus predicting the progression of IgA nephropathy. Methods We collected the data of those patients diagnosed with IgA nephropathy by kidney biopsy performed from May 2017 to April 2018 in the First Affiliated Hospital of Anhui Medical University, and recorded ACR, protein-to-creatinine ratio, 24-hour urine protein, glomerular filtration rate (eGFR), blood pressure, and the Oxford classification. The relationship between urine albumin-to-creatinine ratio, protein-to-creatinine ratio and 24-hour urine protein was analyzed, and the relationship between the three indices and blood pressure, glomerular filtration rate and Oxford classification was discussed separately. Results In the patients with IgAN, ACR, protein-to-creatinine ratio, and 24-hour urine protein, were highly correlated, with the highest correlation between ACR and urine protein-to-creatinine ratio (rs=0.929, P<0.01). They showed good relationships with eGFR and Oxford classification type T and C. There was no statistically significant difference between hypertension, Oxford classification type M, E, S and the above three indices. Conclusions ACR, protein-to-creatinine ratio, and 24-hour urine protein have close relationship. There is significant correlation between the above three indices and glomerular filtration rate and Oxford classification type T and C.

       

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