代谢综合征对IgA肾病患者病情的影响

目的 观察代谢综合征（MS）对IgA肾病（IgAN）患者病情的影响。 方法 从确诊为IgAN的病例中，以并发MS的118例作为IgAN-MS组；另从同年龄范围的IgAN病例中随机抽取118例无并发MS者作为IgAN-非MS组，对比分析两组患者的临床病理资料。 结果 IgAN-MS组的尿蛋白量、Scr、体质量指数、平均动脉压、血三酰甘油、空腹血糖及血尿酸水平均显著高于IgAN-非MS组（P ＜ 0.05或P ＜ 0.01）；血高密度脂蛋白（HDL-C）水平显著低于IgAN-非MS组（P ＜ 0.01）；高血压、糖代谢异常及脂代谢异常患者的百分率也显著高于IgAN-非MS组（P ＜ 0.01）。IgAN-MS组的病理改变显著重于IgAN-非MS组（P ＜ 0.01）。Spearman相关分析显示MS与尿蛋白量、Scr、肾小球损伤指数及肾小管间质损伤指数均呈正相关（P ＜ 0.01）。 结论 MS是IgAN进展的一个危险因素。

Impact of metabolic syndrome on clinicopathology of patients with IgA nephropathy

Objective To investigate the impact of metabolic syndrome(MS)on clinicopathology of IgA nephropathy(IgAN). Methods A total of 118 IgAN patients complicated with MS were enrolled in the study as IgAN-MS group. Then 118 IgAN patients of same age arrange without MS were randomly selected as IgAN-non-MS group.A comparative analysis of clinical and pathological data between these two groups was performed. Results The urine protein, serum creatinine, body mass index, mean arterial pressure, serum triglyceride, fasting blood glucose and serum uric acid in IgAN-MS group were all significantly higher than those in IgAN-non-MS group(P<0.05 or P<0.01). The serum HDL-C level in IgAN-MS group was significantly lower than that in IgAN-non-MS group(P<0.01). The percentages of patient with hypertension, abnormal glucose metabolism or abnormal lipid metabolism in IgAN-MS group were also significantly higher than those in IgAN-non-MS group(P <0.01). The glomerular and tubulointerstitial pathological changes in IgAN-MS group were significantly more severe than those in IgAN-non-MS group(P<0.01). There were significantly positive correlations between MS and urinary protein quantity, serum creatinine level, and glomerular damage index or tubulointerstitial damage index(P<0.01)by Spearman rank correlation analysis. Conclusion MS may be an important risk factor of IgAN progression.