Related factors of hyperuricemia in patients with IgA nephropathy
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摘要: 目的 探讨IgA肾病（IgA nephropathy，IgAN）并高尿酸血症患者相关因素。方法 纳入2015年1月至2019年12月在昆明医科大学第二附属医院肾脏内科行肾穿刺活检诊断为原发性IgAN的患者。根据血尿酸值将患者分为高尿酸组和正常尿酸组，记录患者的基线资料，临床病理特征，并行Logistic回归分析与高尿酸血症发生相关的危险因素。结果 共纳入164例IgAN患者，其中男77例，女87例；年龄（35.54±12.85）岁；高尿酸血症患病率为61.0%（100/164）。与正常血尿酸组比，高血尿酸组的血尿素氮、血肌酐、总胆固醇、24 h尿蛋白定量、收缩压、舒张压、体重指数（body mass index，BMI）水平高；高血压患者比例高；牛津分型血管内皮细胞增生（E）、肾小管萎缩或肾间质纤维化（T）病理损伤更重；Lee氏分级Ⅲ级及以上、慢性肾脏病（chronic kidney disease，CKD）3期及以上和尿隐血除（+++）外构成比均高，而估算肾小球滤过率（estimation of glomerular filtration rate，eGFR）水平较低，差异均有统计学意义（均P<0.05）。多因素Logistic回归分析后结果显示，BMI是IgAN高尿酸血症的独立危险因素（OR=1.141，95%CI 1.033~1.261，P=0.009），且在肾小管萎缩或肾间质纤维化中，以T0为参照，T1、T2均是IgAN高尿酸血症的独立危险因素（T1：OR=2.823，95%CI 1.119~7.121，P=0.028；T2：OR=6.134，95%CI 1.111~33.864，P=0.037）。结论 IgAN患者常伴高尿酸血症，血肌酐升高及肾小球滤过率的下降更明显，肾脏病理慢性变化更重；且肾小管萎缩或肾间质纤维化及BMI是IgAN患者并高血尿酸血症的独立危险因素；高尿酸血症可能在IgAN疾病临床及病理发展过程中发挥重要作用，因此控制血尿酸水平，可能进一步改善IgAN患者预后。
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Keywords:
- Glomerulonephritis, IGA /
- Hyperuricemia /
- Pathological features /
- Risk factors
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