血尿酸与维吾尔族IgA肾病临床及病理的关联性研究

发布时间：2018-04-24 22:18

本文选题：维吾尔族 + IgA肾病　；参考：《石河子大学》2014年硕士论文

【摘要】：目的：探讨血尿酸水平与维吾尔族IgA肾病（IgAN）临床及病理严重程度的关联性，进一步分析维吾尔族IgAN伴高尿酸血症的影响因素。方法：随机选取2012年1月-2013年6月在新疆维吾尔族自治区人民医院经肾活检确诊为原发性IgA肾病维吾尔族患者99例，收集所有纳入研究对象的临床资料（性别、年龄、体重指数、高血压病史、血压、血尿酸、肾功能、尿素氮、胆固醇、甘油三脂、高密度脂蛋白、低密度脂蛋白、尿尿酸、尿肌酐、24h尿蛋白定量）及病理资料。依据血尿酸水平，分为高尿酸血症组和正常血尿酸组，回顾性分析两组临床及病理资料，选用线性相关来分析肾脏病理损伤的影响因素；应用多元线性回归法分析IgA肾病患合并高尿酸血症的危险因素。结果：维吾尔族IgA肾病患者中高血尿酸症的发生率为17.17%；与血尿酸正常组相比，高尿酸血症组的体重指数（BMI）、收缩压、血糖、血肌酐、尿素氮、总胆固醇、甘油三酯、低密度脂蛋白、脂蛋白、24小时尿蛋白定量明显高于血尿酸正常组，肾小球滤过率低于血尿酸正常组（P0.05)；高尿酸血症组的病理Lee氏分级较严重，肾小球损伤程度较重，血尿酸上升到360mmol/L以上水平，肾间质质纤维化的发生率显著升高；Spearman相关分析结果显示：血尿酸、肌酐、24h尿蛋白定量均与肾小球损伤严重程度呈正相关，与肾小球硬化和血管壁病变相关性最强的为血肌酐，，与新月体的形成相关性最强的为血尿酸；多元线性回归分析表明：BMI、男性、血管壁病变、甘油三酯、血肌酐是维吾尔族IgA肾病患者伴发高尿酸血症独立危险因素。结论：维吾尔族IgA肾病合并高尿酸血症的患者临床和病理损伤程度重于IgA肾病血尿酸正常的患者，高尿酸血症可能参与维吾尔族IgA肾病的进展。
[Abstract]:Objective: to investigate the relationship between serum uric acid level and clinical and pathological severity of IgA nephropathy in Uygur nationality, and to analyze the influencing factors of IgAN with hyperuricemia in Uygur nationality. Methods: 99 Uygur patients with primary IgA nephropathy diagnosed by renal biopsy from January 2012 to June 2013 in Xinjiang Uygur Autonomous region people's Hospital were randomly selected, and all the clinical data (sex, age, age) were collected. Body mass index, history of hypertension, blood pressure, uric acid, renal function, urea nitrogen, cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, uric acid, urinary creatinine 24 hours urinary protein quantitative and pathological data. According to the level of serum uric acid, it was divided into hyperuricemia group and normal blood uric acid group. The clinical and pathological data of the two groups were analyzed retrospectively, and the influencing factors of renal pathological injury were analyzed by linear correlation. Multivariate linear regression method was used to analyze the risk factors of IgA nephropathy complicated with hyperuricemia. Results: the incidence of hyperuricemia in Uygur patients with IgA nephropathy was 17.17.The body mass index (BMI), systolic blood pressure (SBP), blood glucose, creatinine, urea nitrogen, total cholesterol, triglyceride in hyperuricemia group were higher than those in normal group. The 24 hour urinary protein quantification of low density lipoprotein and lipoprotein was significantly higher than that of normal serum uric acid group, and the glomerular filtration rate was lower than that of normal serum uric acid group (P 0.05), the pathological Lee's grade of hyperuricemia group was more serious, and the degree of glomerular injury was more serious. The incidence of renal interstitial fibrosis was significantly increased. The results of Spearman correlation analysis showed that serum uric acid and creatinine 24 hours urinary protein were positively correlated with the severity of glomerular injury. The strongest correlation with glomerulosclerosis and vascular wall lesions was serum creatinine, and the strongest correlation with the formation of crescents was serum uric acid. Multivariate linear regression analysis showed that: BMI, male, vascular wall lesion, triglyceride, Serum creatinine is an independent risk factor of hyperuricemia in Uygur patients with IgA nephropathy. Conclusion: the degree of clinical and pathological damage in Uygur patients with IgA nephropathy complicated with hyperuricemia is more serious than that in IgA nephropathy patients with normal serum uric acid. Hyperuricemia may be involved in the progression of Uygur IgA nephropathy.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.31

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