血清尿酸对IgA肾病临床病理及预后的影响

目的 探讨血清尿酸对IgA肾病临床病理及预后的影响。 方法 对我院348例经肾穿刺活检确诊为原发性IgA肾病患者的临床、病理及随访资料进行回顾性分析。 结果 不同肾小球滤过率（GFR）的高尿酸组患者尿蛋白量（24 h）、BUN及Scr等与非高尿酸组患者差异均无统计学意义。高血尿酸组患者球性硬化、肾小管间质积分、血管病变积分的病理改变与非高尿酸组差异有统计学意义（P ＜ 0.05）。随访结束时，高尿酸组GFR下降和终末期肾衰竭的发生率均高于非高尿酸组，分别为40.82%比15.70%和64.71%比35.00%（P ＜ 0.05）。 结论 不同血清尿酸水平的IgA肾病临床表现相似，但病理存在差异，且影响患者的预后。加强血清尿酸水平随访具有重要的意义。

Effect of serum uric acid on clinicopathology and prognosis of IgA nephropathy

Objective To explore the effect of serum uric acid (SUA) on the clinicopathological manifestation and prognosis of IgA nephropathy(IgAN)patients. Methods A total of 348 patients with renal biopsy-proven IgAN in our hospital were enrolled in this study.The data were retrospectively analyzed to examine the association of SUA level with clinicopathological manifestation and prognosis of IgA nephropathy(IgAN)patients. Results There were no significant differences of 24 hour proteinuria,BUN and Scr between patients of high SUA level with various GFR and those of normal SUA level.While differences of glomerular sclerosis,tubulointerstitial scores and vascular injury between these two groups were significant (P＜0.05).At the end of follow-up,prevalence of GFR decline and ESRD was significantly higher in patients with high SUA as compared to those with normal SUA(40.82%vs 15.70%,64.71% vs 35.00%,respectively,P＜0.05). Conclusions Patients with different SUA levels have similar clinical manifestations,but different pathological findings and prognosis.It is important to pay attention to the follow-up of SUA level in IgAN patients.