小动脉透明样变与IgA肾病合并高血压患者的临床病理特征相关性分析

沈云竹; 熊加川; 赵景宏

doi:10.16016/j.2097-0927.202201103

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小动脉透明样变与IgA肾病合并高血压患者的临床病理特征相关性分析

临床医学 | 更新时间：2026-01-09

- 小动脉透明样变与IgA肾病合并高血压患者的临床病理特征相关性分析
- Correlation of arteriolar hyalinosis and clinicopathological features in patients with IgA nephropathy and hypertension
- 陆军军医大学学报 2022年44卷第8期页码：805-811
- 作者机构：
  
  400037 重庆，陆军军医大学(第三军医大学)第二附属医院肾内科，全军肾脏病中心，重庆市慢性肾脏病防治重点实验室，重庆市肾病与泌尿系统疾病临床医学研究中心
- 作者简介：
  
  [赵景宏，E-mail: zhaojh@tmmu.edu.cn ZHAO Jinghong, E-mail: zhaojh@tmmu.edu.cn
- 基金信息：
  
  陆军军医大学临床医学科研人才培养计划(2018XLC1007)
- DOI：10.16016/j.2097-0927.202201103
  中图分类号： R543.5;R544.1;R692.31
- 收稿：2022-01-12，
  
  修回：2022-03-01，
  
  纸质出版：2022-04-30
- 稿件说明：
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沈云竹, 熊加川, 赵景宏. 小动脉透明样变与IgA肾病合并高血压患者的临床病理特征相关性分析[J]. 陆军军医大学学报, 2022,44(8):805-811.

Yunzhu SHEN, Jiachuan XIONG, Jinghong ZHAO. Correlation of arteriolar hyalinosis and clinicopathological features in patients with IgA nephropathy and hypertension[J]. Journal of Army Medical University, 2022, 44(8): 805-811.
沈云竹, 熊加川, 赵景宏. 小动脉透明样变与IgA肾病合并高血压患者的临床病理特征相关性分析[J]. 陆军军医大学学报, 2022,44(8):805-811. DOI： 10.16016/j.2097-0927.202201103.

Yunzhu SHEN, Jiachuan XIONG, Jinghong ZHAO. Correlation of arteriolar hyalinosis and clinicopathological features in patients with IgA nephropathy and hypertension[J]. Journal of Army Medical University, 2022, 44(8): 805-811. DOI： 10.16016/j.2097-0927.202201103.

摘要

目的

探究伴或不伴小动脉透明样变与免疫球蛋白A(Immunoglobulin A

IgA)肾病合并高血压患者临床指标和病理特征的差异性。

方法

收集2012-2018年在我院经肾活检确诊为IgA肾病且合并高血压的患者246例，根据小动脉透明样变程度将患者分为无小动脉透明样变组(

=73)，轻度小动脉透明样变组(

=136，病变程度: 1%~25%)和中度小动脉透明样变组(

=37，病变程度: 26%~50%)共3组，比较各组的临床病理资料及与小动脉透明样变的相关性。

结果

IgA肾病合并高血压患者轻度小动脉透明样变发生率最高(55.3%)。临床指标中，肿瘤坏死因子α(TNF-α)、尿素、肌酐、尿酸及估算的肾小球滤过率(eGFR)在3组间差异有统计学意义(

＜0.05)。病理指标中，肾小球硬化率、肾小球系膜细胞增生(M)、节段性肾小球硬化(S)、肾小管萎缩或间质纤维化(T)及Lee分级3组间差异有统计学意义(

＜0.05)。相关性分析提示，小动脉透明样变性与Lee分级(

=0.433，

＜0.001)、肌酐(

=0.319，

＜0.001)及肾小管萎缩/间质纤维化(

=0.317，

＜0.001)正相关关系最强，与eGFR负相关关系最强(

=-0.367

＜0.001)。

结论

IgA肾病合并高血压患者伴或不伴小动脉透明样变的临床及病理指标均存在显著差异，小动脉透明样变的严重程度与IgA肾病合并高血压患者的肾功能密切相关，可作为评价肾功能改变的指标。

Abstract

Objective

To explore the differences in clinical indicators and clinicopathological characteristics immunoglobulin A nephropathy (IgAN) patients with hypertension accompanied with arteriolar hyalinosis and those without.

Methods

A total of 246 patients who was diagnosed with biopsy-proven primary IgAN and hypertension in our hospital from 2012 to 2018 were enrolled in our study. According to the severity of arteriolar hyalinosis

they were divided into 3 groups

without (

=73) and with mild (

=136

severity: 1%~25%) and

moderate arteriolar hyalinosis (

=37

severity: 26%~50%)

respectively. The correlations of clinicopathological parameters with arteriolar hyalinosis were analyzed in the groups.

Results

The incidence (55.3%) of mild arteriolar hyalinosis was the highest in the patients. There were significant differences in tumor necrosis factor-α (TNF-α)

urea

serum creatinine (Scr)

uric acid

and estimated glomerular filtration rate (eGFR) among the 3 groups (

0.05). In clinicopathological parameters

glomerulosclerosis

mesangial hypercellularity (M)

segmental sclerosis (S)

and interstitial fibrosis/tubular atrophy (T) lesions and grades of Lee classification differed statistically among the 3 groups (

0.05). Moreover

correlation analysis showed that arteriolar hyalinosis had a strong positive correlation with grade of Lee classification (

=0.433

0.001)

Scr (

=0.319

0.001) and T (

=0.317

0.001)

respectively

while a strong negative correlation with eGFR (

=-0.367

0.001).

Conclusion

Significant differences are observed in clinical and pathological indicators in patients with IgAN and hypertension accompanied with arteriolar hyalinosis or not. Its severity is closely associated with renal function

so arteriolar hyalinosis can be used as an indicator to evaluate the function.

关键词

Keywords

references

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