论文部分内容阅读
目的:研究探讨IgA肾病的病理分级与实验室指标的检测结果。方法:123例均选择行肾穿刺活检确诊的IgA肾病患者123例。分为牌肾气虚、肝肾阴虚、气阴两虚3型。其中脾肾气虚型40例;肝肾阴虚型24例;气阴两虚型59例。通过血压及生化指标检测:肾活检前1周内测定收缩压(SBP)、舒张压(DBP)、24h尿蛋白定量、肌酐(SCr)、尿素氮(BUN)、内生肌酐清除率(Ccr)、白蛋白(Alb)、总胆固醇(TC)、甘油三酯(TG),血清IgA、IgG、IgM、C3。肾组织光镜:病理标本根据Lee分级标准将IgA肾病分为I～V级。结果:三组证型中肝肾阴虚型SCr水平明显高于其他两型(P<0.01);3组间Ccr、BUN、TG、IgA、IgM、C3、DBP含量两两比较差异无统计学意义(P>0.05)。脾肾气虚型Alb水平低于气阴两虚型(P<0.05),24h尿蛋白定量大于气阴两虚型(P<0.05);脾肾气虚型TC水平高于肝肾阴虚和气阴两虚型(P<0.01);肝肾阴虚型IgG水平低于气阴两虚型(P<0.05),脾肾气虚型和肝肾阴虚型IgG水平差异无统计学意义(P>0.05);肝肾阴虚型SBP高于气阴两虚型(P<0.05)。各证型患者病理分级中Ⅲ级～Ⅳ级最多见,共95例占77.24%。脾肾气虚型病理分级百分比相对级别较低,而肝肾阴虚型病理分级百分比相对级别较高,但各证型之间比较差异无统计学意义(P>0.05)。结论:通过IgA肾病的病理分级可对实验室指标的早期检测具有重要的临床意义。
Objective: To investigate the pathological grade of IgA nephropathy and laboratory test results. Methods: A total of 123 patients with IgA nephropathy confirmed by renal biopsy were selected in 123 cases. Divided into card kidney deficiency, liver and kidney, Qi and Yin deficiency type 3. Which 40 cases of spleen and kidney Qi; liver and kidney Yin 24 cases; Qi and Yin Deficiency in 59 cases. Blood pressure and biochemical parameters were measured: systolic blood pressure (SBP), diastolic blood pressure (DBP), 24h urinary protein, creatinine (SCr), blood urea nitrogen (BUN) and endogenous creatinine clearance (Ccr) Alb, TC, TG, serum IgA, IgG, IgM and C3. Renal microscopy: Pathological specimens according to Lee grading standards IgA nephropathy is divided into I ~ V level. Results: There was no significant difference in Cr, BUN, TG, IgA, IgM, C3 and DBP levels between the three groups in all three syndromes (P <0.01) Significance (P> 0.05). The levels of Alb in spleen and kidney qi deficiency group were lower than that in qi and yin deficiency group (P <0.05), and the urinary protein excretion in 24h group was greater than that of qi and yin deficiency group (P <0.05) (P <0.01). The level of IgG in liver-kidney-yin deficiency group was lower than that in qi-yin deficiency group (P <0.05), there was no significant difference in IgG level between qi-deficiency of spleen and kidney and liver- (P <0.05). The SBP of liver-kidney-yin deficiency was higher than that of qi-yin deficiency (P <0.05). The pathological grading of all types of patients in grade Ⅲ ~ Ⅳ most common, a total of 95 cases accounted for 77.24%. The pathological grade of spleen and kidney qi deficiency relative lower level, while the relative percentage of liver and kidney yin pathological grade higher, but there was no significant difference between the various syndromes (P> 0.05). Conclusion: The pathological grading of IgA nephropathy may have important clinical significance for the early detection of laboratory indexes.