腎小球C4d沉積為IgA腎病的預(yù)后因子
發(fā)布時(shí)間：2018-09-07 18:51
【摘要】：目的探討腎小球補(bǔ)體C4d沉積在評(píng)估Ig A腎病嚴(yán)重程度及判斷預(yù)后中的意義。方法免疫熒光法檢測(cè)Ig A腎病患者腎組織C4d沉積情況,分析C4d沉積與臨床、病理指標(biāo)以及腎臟緩解間的關(guān)系。結(jié)果納入131例Ig A腎病患者,30例存在腎小球C4d沉積。與無(wú)C4d沉積者相比,腎小球C4d沉積者血肌酐、尿蛋白、C4d水平及高血壓發(fā)生率更高,但腎小球?yàn)V過(guò)率明顯降低。隨Lee分級(jí)病理表型加重,腎小球C4d沉積者比例增加(P=0.005)。C4d沉積者系膜增生、內(nèi)皮增生、局灶節(jié)段腎小球硬化及小管間質(zhì)損害更重。腎小球C4d沉積者腎臟緩解率明顯低于無(wú)C4d沉積者(P0.001)。結(jié)論存在腎小球C4d沉積的Ig A腎病患者臨床和病理表現(xiàn)更重,腎臟緩解率更低。腎小球C4d沉積可望成為判斷Ig A腎病預(yù)后重要的病理預(yù)測(cè)因子。
[Abstract]:Objective to investigate the significance of glomerular complement C 4 d deposition in evaluating the severity and prognosis of Ig A nephropathy. Methods Immunofluorescence assay was used to detect C4d deposition in renal tissue of patients with Ig A nephropathy, and the relationship between C4d deposition and clinical, pathological indexes and renal remission was analyzed. Results glomerular C 4 d deposition was found in 30 patients with Ig A nephropathy. Compared with those without C4d deposition, the serum creatinine and urinary protein C4d levels and the incidence of hypertension were higher in glomerular C4d deposits, but the glomerular filtration rate was significantly lower. The ratio of glomerular C4d deposition increased (P0. 005). C4d deposition increased Mesangial hyperplasia, endothelial hyperplasia, focal segmental glomerulosclerosis and tubulointerstitial damage. The renal remission rate of glomerular C 4 d deposition was significantly lower than that of non C 4 d deposition (P 0.001). Conclusion patients with Ig A nephropathy with glomerular C 4 d deposition have more severe clinical and pathological manifestations and lower renal remission rate. Glomerular C 4 d deposition is expected to be an important prognostic factor for Ig A nephropathy.
【作者單位】： 中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院腎內(nèi)科;
【基金】：國(guó)家自然科學(xué)基金青年項(xiàng)目(81500525) 遼寧省自然科學(xué)基金(2014021046) 沈陽(yáng)市科技計(jì)劃(F16-206-9-04)
【分類號(hào)】：R692.31
本文編號(hào)：2229123
[Abstract]:Objective to investigate the significance of glomerular complement C 4 d deposition in evaluating the severity and prognosis of Ig A nephropathy. Methods Immunofluorescence assay was used to detect C4d deposition in renal tissue of patients with Ig A nephropathy, and the relationship between C4d deposition and clinical, pathological indexes and renal remission was analyzed. Results glomerular C 4 d deposition was found in 30 patients with Ig A nephropathy. Compared with those without C4d deposition, the serum creatinine and urinary protein C4d levels and the incidence of hypertension were higher in glomerular C4d deposits, but the glomerular filtration rate was significantly lower. The ratio of glomerular C4d deposition increased (P0. 005). C4d deposition increased Mesangial hyperplasia, endothelial hyperplasia, focal segmental glomerulosclerosis and tubulointerstitial damage. The renal remission rate of glomerular C 4 d deposition was significantly lower than that of non C 4 d deposition (P 0.001). Conclusion patients with Ig A nephropathy with glomerular C 4 d deposition have more severe clinical and pathological manifestations and lower renal remission rate. Glomerular C 4 d deposition is expected to be an important prognostic factor for Ig A nephropathy.
【作者單位】： 中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院腎內(nèi)科;
【基金】：國(guó)家自然科學(xué)基金青年項(xiàng)目(81500525) 遼寧省自然科學(xué)基金(2014021046) 沈陽(yáng)市科技計(jì)劃(F16-206-9-04)
【分類號(hào)】：R692.31
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