[1]赵雪千,王雯瑾,张楠辉,等.IgA肾病患者补体血清水平及其系膜沉积强度与肾病理损伤程度的相关性[J].陕西医学杂志,2025,54(4):555-559.[doi:DOI:10.3969/j.issn.1000-7377.2025.04.024]
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IgA肾病患者补体血清水平及其系膜沉积强度与肾病理损伤程度的相关性
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年4期
页码:
555-559
栏目:
临床病理
出版日期:
2025-04-05

文章信息/Info

作者:
赵雪千; 王雯瑾; 张楠辉; 陈文慧; 魏 丽
(襄阳市第一人民医院肾内科,湖北 襄阳 441000)
关键词:
肾小球肾炎 IgA;  补体C3;  补体C4;  肾活检;  肾病理;  终末期肾病
分类号:
R 692.6
DOI:
DOI:10.3969/j.issn.1000-7377.2025.04.024
文献标志码:
A
摘要:
目的:探讨IgA肾病(IgAN)患者血清补体水平及其肾脏补体沉积强度对肾脏病理损伤程度的影响。方法:回顾性收集经肾活检确诊的原发性IgAN患者的临床及病理资料,根据IgAN牛津病理分型标准将患者分为肾病理损伤轻度组(<3项病理分型)和重度组(≥3项病理分型),比较两组之间血清补体水平、肾脏系膜区补体沉积强度及其他临床指标的差异。再根据补体C3在系膜区沉积强度分为阴性组(-或±)和阳性组(≥1+),比较两组患者肾脏牛津病理分型(MESTC)之间的差异。结果:共118例IgAN患者入选该项研究,男性64例(54.24%),根据IgAN牛津病理分型,肾脏病理损伤轻度组(<3分)62例,重度组(≥3分)56例,两组比较,重度组血红蛋白、白蛋白、eGFR、血清C3、C3/C4均较低,肌酐、IgA/C3、镜下血尿、24 h尿蛋白量、系膜区C3沉积比例均较高(均P<0.05)。单因素Logistic回归分析结果显示,血红蛋白、eGFR、血清补体C3、IgA/C3、C3/C4、系膜区C3沉积强度是IgAN患者病理损伤轻重程度的相关因素(均P<0.05); 多因素Logistic回归分析显示,血清补体C3水平是IgAN患者病理损伤轻重程度的独立因素(0R=0.147,95%CI 0.026～0.829,P<0.05)。根据补体C3肾脏系膜区沉积分组后,两组资料比较,阳性组M1、S1、C1～2比例更高。结论:血清C3补体水平下降是IgAN患者肾脏病理损伤程度的独立危险因素; IgAN肾脏C3系膜区沉积阳性组较阴性组比较,系膜细胞增殖、节段性硬化或粘连、新月体发生的比例更高。

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备注/Memo

备注/Memo:
[基金项目]湖北省自然科学基金资助立项课题(2022CFB873)
更新日期/Last Update: 2025-04-07