本文選題：高尿酸血癥 + IgA腎病��； 參考：《蚌埠醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的通過對(duì)臨床和病理指標(biāo)進(jìn)行分析,探究原發(fā)性Ig A腎病出現(xiàn)高尿酸血癥的病因及危害,為延緩IgA腎病進(jìn)展提供臨床指導(dǎo)依據(jù)。方法收集2015年1月至2016年12月期間在蚌埠醫(yī)學(xué)院第一附屬醫(yī)院住院患者64例,經(jīng)皮腎穿刺活檢組織檢查明確診斷為原發(fā)性Ig A腎病。根據(jù)血尿酸水平分為血尿酸正常組和高尿酸血癥組。觀察指標(biāo):性別、初次腎活檢時(shí)年齡、病程、血壓、血尿酸、血肌酐、血尿素氮、血漿白蛋白、血甘油三酯、血膽固醇、24小時(shí)尿蛋白定量、腎臟病理Lee氏分級(jí)。對(duì)上述資料進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果1.本研究64例原發(fā)性Ig A腎病患者占腎穿刺總?cè)藬?shù)的31.4%,高尿酸血癥在原發(fā)性Ig A腎病中的發(fā)病率為35.9%。2.本研究中,Ig A腎病患者高尿酸血癥組有4例腎功能正常、19例腎功能異常,血尿酸正常組有26例腎功能正常、15例腎功能異常。高尿酸血癥組與血尿酸正常組之間腎功能異常者與腎功能正常者所占比例差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3.分別比較Ig A腎病患者高尿酸血癥組與血尿酸正常組的病程、年齡、血膽固醇、血甘油三酯、血白蛋白,其差異均無統(tǒng)計(jì)學(xué)意義(P0.05),而兩組間血肌酐、血尿素氮、24小時(shí)尿蛋白定量、血壓的差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.高尿酸血癥在Ig A腎病患者Lee氏分級(jí)II級(jí)、III級(jí)、IV級(jí)中的構(gòu)成比分別為6.7%、44.4%、46.2%,II級(jí)、III級(jí)、IV級(jí)中高尿酸血癥的構(gòu)成比差異存在統(tǒng)計(jì)學(xué)意義(P0.05)。5.應(yīng)用SPearman法分析Ig A腎病患者,其血尿酸水平與年齡、病程、血膽固醇、血甘油三酯、血漿白蛋白無相關(guān)性;與血尿素氮、24小時(shí)尿蛋白定量、Lee氏分級(jí)呈正相關(guān),與e GFR呈負(fù)相關(guān)。e GFR與Lee氏分級(jí)呈負(fù)相關(guān),血尿素氮、24小時(shí)尿蛋白定量分別與Lee氏分級(jí)呈正相關(guān)。6.經(jīng)多因素Logistic回歸分析顯示:男性、高齡、高尿酸血癥是原發(fā)性Ig A腎病的危險(xiǎn)因素。結(jié)論1.原發(fā)性Ig A腎病并發(fā)高尿酸血癥者較其他病理類型比例高。2.原發(fā)性Ig A腎病患者血尿酸水平與血尿素氮、24小時(shí)尿蛋白定量、Lee氏分級(jí)呈正性相關(guān),與e GFR呈負(fù)性相關(guān),應(yīng)注意按時(shí)監(jiān)測(cè)上述指標(biāo),以便及時(shí)發(fā)現(xiàn)原發(fā)性Ig A腎病有無進(jìn)展。3.高尿酸血癥是原發(fā)性Ig A腎病的顯著危險(xiǎn)因素,臨床醫(yī)生應(yīng)控制Ig A腎病患者的血尿酸水平,并對(duì)患者進(jìn)行宣教,這對(duì)治療Ig A腎病和延緩腎臟疾病進(jìn)展具有一定的指導(dǎo)意義。
[Abstract]:Objective to explore the etiology and harm of hyperuricemia in primary IgA nephropathy by analyzing the clinical and pathological indexes, and to provide clinical guidance for delaying the progression of IgA nephropathy. Methods from January 2015 to December 2016, 64 hospitalized patients in the first affiliated Hospital of Bengbu Medical College were selected and diagnosed as primary IgA nephropathy by percutaneous renal biopsy. According to the level of serum uric acid, it was divided into normal group and hyperuricemia group. Outcome measures: sex, age at first renal biopsy, course of disease, blood pressure, serum uric acid, serum creatinine, blood urea nitrogen, plasma albumin, serum triglyceride, serum cholesterol 24 hours urinary protein quantitative, renal pathological Lee's grade. The above data were analyzed statistically. Result 1. In this study, 64 patients with primary IgA nephropathy accounted for 31.4% of the total number of renal puncture. The incidence of hyperuricemia in primary IgA nephropathy was 35.90.2. In this study, there were 4 cases with normal renal function and 19 cases with abnormal renal function in hyperuricemia group and 26 cases with normal renal function in normal blood uric acid group. There was significant difference in the proportion of abnormal renal function and normal renal function between hyperuricemia group and normal blood uric acid group. The course, age, serum cholesterol, serum triglyceride and serum albumin of patients with hyperuricemia and normal serum uric acid in patients with IgA nephropathy were compared respectively. There was no significant difference in serum creatinine between the two groups. The blood urea nitrogen in 24 hours urine protein quantity, the blood pressure difference has the statistical significance (P 0.05. 4). The compositional ratios of hyperuricemia in patients with IgA nephropathy were 6.7in Lee's grade II and 44.42 in grade 鈪，

本文編號(hào)：2021629