微创医学

目的探讨原发性IgA肾病患者伴高脂血症的临床表现特点与病理特征及其相关性。方法对肾穿刺后行病理诊断为原发性IgA肾病的116例患者进行回顾性分析，收集临床资料，病理资料。根据患者血脂水平分为高脂血症组和非高脂血症组，对两组患者的一般情况、临床指标及病理情况进行比较。结果 116例IgA肾病患者，高血脂组57例，非高脂血症组59例。血脂升高组与血脂正常组相比较，血肌酐、血尿酸、血尿素氮、24H尿蛋白定量均增高，eGFR降低，而肾穿年龄、收缩压、舒张压、Hb、Alb、C3、IgA等与血脂正常组相比，无明显统计学差异。高血脂组病理特点相较于正常组，肾小管/间质萎缩较严重。结论伴有血脂升高的IgA肾病者肾功能较血脂正常的IgA肾病患者差，肾脏病理损害严重。

Objective To investigate the correlation between clinical manifestations and pathological characteristics in patients with primary IgA nephropathy with hyperlipidemia. Methods 116 patients pathologically were diagnosed as primary IgA nephropathy by renal biopsy. And clinical and pathological data of all patients was retrospectively reviewed. Patients were divided into hyperlipidaemia group and nonhyperlipidaemia group on the basis of their serum lipid level. The general condition, clinical manifestations and pathological data were analyzed and compared between two groups. Results There were 57 cases in the hyperlipidaemia group and 59 in the nonhyperlipidaemia group. The serum creatinine, serum uric acid, serum urea nitrogen and 24h urine protein were higher, and glomerular filtration rate (GFR) was lower in the hyperlipidaemia group compared with the nonhyperlipidaemia group. There were no significant difference between two groups in the age at biopsy, systolic blood pressure, diastolic blood pressure, hemoglobin, plasma albumin and IgA level. Renal tubular/interstitial atrophy was more serious in the hyperlipidaemia group than that in the normal group. Conclusions Compared with patients diagnosed as IgA nephropathy with normal serum lipid level, the renal function and renal pathological damage are worse in patients with IgA nephropathy with hyperlipidaemia.