本文選題：IgA腎病　切入點：腎血管病變　出處：《寧夏醫(yī)科大學》2014年碩士論文

【摘要】：目的探討IgA腎�。↖gAN）腎血管病變與預(yù)后不良因素的相關(guān)性。方法將100例經(jīng)腎活檢確診的原發(fā)性IgAN患者分為腎血管病變組和無血管病變組，進行對照研究，比較兩組臨床指標、病理改變的差異，探討各臨床指標、病理變化與血管病變之間的關(guān)系。結(jié)果100例IgAN患者中有腎血管病變者70例，占70%，，就本研究所觀察到的腎血管病變特點及結(jié)合IgAN的病理改變，將血管病變分為3型：動脈玻璃樣變型，動脈硬化型，動脈內(nèi)膜增厚型，其發(fā)生率所占百分比分別為47.1%、28.6%、24.3%。無腎血管病變者30例，占30%。與無腎血管病變組相比，腎血管病變組單因素分析結(jié)果表明，高血壓發(fā)生率、24h尿蛋白、血肌酐、血尿酸升高、血白蛋白降低均高于無腎血管病變組（P＜0.05）；病理學檢查中腎小球硬化、腎間質(zhì)纖維化、新月體形成、炎性細胞浸潤病理表現(xiàn)發(fā)生率明顯高于無腎血管病變組（P＜0.05）。多因素非條件logistic回歸分析結(jié)果表明，高血壓[OR=7.728，95%CI（1.708-34.964）]、24h尿蛋白定量[OR=20.022,95%CI(3.869103.623)]、腎小球硬化[OR=12.093,95%CI(2.43160.149)]、腎間質(zhì)纖維化[OR=8.511,95%CI(1.33254.396)]，說明以上4個預(yù)后不良因素與IgAN腎血管病變成正性相關(guān)。結(jié)論IgAN預(yù)后不良因素：高血壓、大量蛋白尿、腎小球硬化、腎間質(zhì)纖維化與IgAN腎血管病變密切相關(guān)，進一步推斷腎血管病變可作為判斷預(yù)后的一項重要病理指標。
[Abstract]:Objective to investigate the correlation between renal vascular disease and poor prognosis in patients with IgA nephropathy. Methods 100 patients with primary IgAN diagnosed by renal biopsy were divided into two groups: renal vascular lesion group and non-vascular lesion group, and the clinical indexes were compared between the two groups. Results there were 70 cases (70%) with renal vascular lesions in 100 cases of IgAN. The characteristics of renal vascular lesions and the pathological changes combined with IgAN were observed in this study. The vascular lesions were divided into three types: glassy type, atherosclerosis type and intimal thickening type. The incidence of vascular lesions was 47.1% and 28.6%, respectively. 30 cases (30%) had no renal vascular lesions, which were compared with those without renal vascular lesions. The results of univariate analysis showed that the incidence of hypertension in 24 hours urine protein, serum creatinine, serum uric acid increased, serum albumin decreased than that in no renal vascular disease group (P < 0.05), glomerulosclerosis, renal interstitial fibrosis in pathological examination. The pathological features of crescents and inflammatory cell infiltration were significantly higher than those in the patients without renal vascular disease (P < 0.05). The results of multivariate conditional logistic regression analysis showed that: 1. Hypertension [OR7.728995 CIQ 1.708-34.964] 24 h urinary protein quantification [OR20. 022 + 95 CIQ 3.869 103.623], glomerulosclerosis [ORP 12.093 + 95CI2.43160.149], interstitial fibrosis [OR8.51195CI1 1.33254.396], indicating that the above four prognostic factors are positively related to IgAN renal angiopathy. Conclusion: hypertension, massive albuminuria, glomerulus, glomerulus, glomerulus, renal fibrosis, renal interstitial fibrosis (OR8.51195CI1.33254.396). Renal interstitial fibrosis is closely related to renal vascular lesions in IgAN.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R692.31

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