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目的探讨IgA肾病肾血管病变的危险因素。方法回顾性分析2000年1月-2009年6月间经肾活检确诊的175例IgA肾病患者资料,其中有肾血管病变者93例,无肾血管病变者82例,进行对照研究。采用多因素非条件logistic回归模型分析影响IgA肾病肾血管病变的危险因素。结果高血压[OR=11.593,P=0.001,95%CI(2.800,47.991)]、24h尿蛋白定量[OR=1.754,P=0.001,95%CI(1.270,2.424)]、血肌酐[OR=1.005,P=0.001,95%CI(1.002,1.008)]、肾小球硬化[OR=8.341,P=0.000,95%CI(2.716,25.610)]、肾间质纤维化[OR=4.880,P=0.014,95%CI(1.385,17.199)]对IgA肾病肾血管病变的影响有统计学意义。结论高血压、24h尿蛋白定量、血肌酐、肾小球硬化和肾间质纤维化可能是影响IgA肾病肾血管病变的独立危险因素。积极控制以上危险因素对延缓IgA肾病病变的进展具有重要意义。
Objective To investigate the risk factors of renal angiopathy in IgA nephropathy. Methods The data of 175 patients with IgA nephropathy confirmed by renal biopsy from January 2000 to June 2009 were retrospectively analyzed. Among them, there were 93 cases with renal vascular disease and 82 cases without renal vascular disease. The multivariate non-conditional logistic regression model was used to analyze the risk factors of renal vascular disease affecting IgA nephropathy. Results Serum creatinine [OR = 11.593, P = 0.001,95% CI (2.800, 47.991)], urinary protein excretion in 24 hours [OR = 1.754, P = 0.001,95% CI 1.005, P = 0.001, 95% CI (1.002, 1.008)], glomerulosclerosis [OR = 8.341, P = 0.000,95% CI (2.716,25.610)], renal interstitial fibrosis [OR = 4.880, P = 0.014, 95% CI (1.385, 17.199)] had a significant effect on IgA nephropathy and renal disease. Conclusions Hypertension, urinary protein excretion in 24h, serum creatinine, glomerulosclerosis and interstitial fibrosis may be independent risk factors of renal vascular disease in IgA nephropathy. Active control of the above risk factors for the delaying the progression of IgA nephropathy is of great significance.