肾小球C4d沉积为IgA肾病的预后因子
发布时间：2018-09-07 18:51
【摘要】：目的探讨肾小球补体C4d沉积在评估Ig A肾病严重程度及判断预后中的意义。方法免疫荧光法检测Ig A肾病患者肾组织C4d沉积情况,分析C4d沉积与临床、病理指标以及肾脏缓解间的关系。结果纳入131例Ig A肾病患者,30例存在肾小球C4d沉积。与无C4d沉积者相比,肾小球C4d沉积者血肌酐、尿蛋白、C4d水平及高血压发生率更高,但肾小球滤过率明显降低。随Lee分级病理表型加重,肾小球C4d沉积者比例增加(P=0.005)。C4d沉积者系膜增生、内皮增生、局灶节段肾小球硬化及小管间质损害更重。肾小球C4d沉积者肾脏缓解率明显低于无C4d沉积者(P0.001)。结论存在肾小球C4d沉积的Ig A肾病患者临床和病理表现更重,肾脏缓解率更低。肾小球C4d沉积可望成为判断Ig A肾病预后重要的病理预测因子。
[Abstract]:Objective to investigate the significance of glomerular complement C 4 d deposition in evaluating the severity and prognosis of Ig A nephropathy. Methods Immunofluorescence assay was used to detect C4d deposition in renal tissue of patients with Ig A nephropathy, and the relationship between C4d deposition and clinical, pathological indexes and renal remission was analyzed. Results glomerular C 4 d deposition was found in 30 patients with Ig A nephropathy. Compared with those without C4d deposition, the serum creatinine and urinary protein C4d levels and the incidence of hypertension were higher in glomerular C4d deposits, but the glomerular filtration rate was significantly lower. The ratio of glomerular C4d deposition increased (P0. 005). C4d deposition increased Mesangial hyperplasia, endothelial hyperplasia, focal segmental glomerulosclerosis and tubulointerstitial damage. The renal remission rate of glomerular C 4 d deposition was significantly lower than that of non C 4 d deposition (P 0.001). Conclusion patients with Ig A nephropathy with glomerular C 4 d deposition have more severe clinical and pathological manifestations and lower renal remission rate. Glomerular C 4 d deposition is expected to be an important prognostic factor for Ig A nephropathy.
【作者单位】： 中国医科大学附属第一医院肾内科;
【基金】：国家自然科学基金青年项目(81500525) 辽宁省自然科学基金(2014021046) 沈阳市科技计划(F16-206-9-04)
【分类号】：R692.31
本文编号：2229123
[Abstract]:Objective to investigate the significance of glomerular complement C 4 d deposition in evaluating the severity and prognosis of Ig A nephropathy. Methods Immunofluorescence assay was used to detect C4d deposition in renal tissue of patients with Ig A nephropathy, and the relationship between C4d deposition and clinical, pathological indexes and renal remission was analyzed. Results glomerular C 4 d deposition was found in 30 patients with Ig A nephropathy. Compared with those without C4d deposition, the serum creatinine and urinary protein C4d levels and the incidence of hypertension were higher in glomerular C4d deposits, but the glomerular filtration rate was significantly lower. The ratio of glomerular C4d deposition increased (P0. 005). C4d deposition increased Mesangial hyperplasia, endothelial hyperplasia, focal segmental glomerulosclerosis and tubulointerstitial damage. The renal remission rate of glomerular C 4 d deposition was significantly lower than that of non C 4 d deposition (P 0.001). Conclusion patients with Ig A nephropathy with glomerular C 4 d deposition have more severe clinical and pathological manifestations and lower renal remission rate. Glomerular C 4 d deposition is expected to be an important prognostic factor for Ig A nephropathy.
【作者单位】： 中国医科大学附属第一医院肾内科;
【基金】：国家自然科学基金青年项目(81500525) 辽宁省自然科学基金(2014021046) 沈阳市科技计划(F16-206-9-04)
【分类号】：R692.31
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