不同性别IgA肾病患者合并高尿酸血症的临床研究

目的探讨不同性别IgA肾病患者合并高尿酸血症的临床及肾脏病理特点。方法采用回顾性研究方法,将2008年1月-2010年12月收治的226例经肾活检确诊的原发性IgA肾病患者分为男性高尿酸血症组、男性尿酸正常组、女性高尿酸血症组及女性尿酸正常组4组,统计分析4组的临床指标及病理指标。结果高尿酸血症患病率男性(21.7%)高于女性(11.9%),差异有统计学意义(P<0.01),尿检异常型患病率男性(14.6%)高于女性(4.0%),差异有统计学意义(P<0.01),女性LeeⅢ级的患病率(7.1%)高于男性(5.8%),差异有统计学意义(P<0.01);男性高尿酸血症组的尿素氮高于尿酸正常组(P<0.05),女性高尿酸血症组的血尿素氮、血肌酐、胱抑素C、舒张压、甘油三酯比尿酸正常者明显增高(P<0.01),女性高尿酸血症组的高密度脂蛋白明显高于男性组(P<0.01)。结论高尿酸血症是IgA肾病的危险因素,可导致更严重的肾功能损害及肾脏病理损害,这种影响在不同性别中存在差异。

Clinical Research of IgA Nephropathy Associated with Hyperuricemia in Different Gender

Objective To investigate the clinical and pathological features of IgA nephropathy associated hyperuricemia in different gender.Methods We retrospectively reviewed the clinical data of 226 patients with biopsy-proved primary IgA nephropathy from January 2008 to December 2010.The patients were divided into male hyperuricemia group,male normouricemia group,female hyperuricemia group and female normouricemia group;then we analyzed and compared the clinical and pathological features among the groups.Results Prevalence of hyperuricemia in the males was higher than that in the females(21.7%,11.9%;P<0.01),the same as the prevalence of asymptomatic abnormal urinalysis clinical type(14.6%,4.0%;P<0.01).Prevalence of LeeⅢ grade in female patients was higher than that in male patients(7.1%,5.8%;P<0.01).Blood urea nitrogen(BUN) in male hyperuricemia group was higher than that in male normouricemia group(P<0.05).BUN,serum creatinine,cystatin C,diastolic blood pressure and triglyceride in female hyperuricemia group were significantly higher than those in female normouricemia group(P<0.01).High density lipoprotein in female hyperuricemia group was significantly higher than that in male group(P<0.01).Conclusion As causing more serious impaired renal functional and pathological damage,hyperuricemia is a risk factor of IgA nephropathy and has different effect in different gender.