摘要
目的:研究老年Ig A肾病患者的临床病理相关性及影响预后的危险因素。方法:回顾性分析年龄≥60岁的原发性Ig A肾病患者的临床、病理资料及随访资料。结果:本研究共入选87例患者,平均年龄(64.9±3.9)岁。临床病理相关性分析显示,基线e GFR与牛津分型的M、T和C分别存在显著负相关关系,24 h尿蛋白定量与牛津分型的M、T和C呈正相关关系。多因素COX回归分析显示,基线e GFR(HR=0.246;95%CI 0.118~0.514)、肾小管萎缩/间质纤维化改变(HR=35.087;95%CI 1.850~665.329)、细胞性/细胞纤维性新月体形成(HR=8.061;95%CI 1.000~64.985)、细动脉透明样变性(HR=9.231;95%CI 1.900~44.836)、球性硬化比例(HR=1.033;95%CI 1.002~1.065)是老年Ig A肾病患者进展至ESRD的独立危险因素。结论:老年Ig A肾病患者的基线e GFR、与肾小管萎缩/间质纤维化、新月体形成、肾小球球性硬化、细动脉透明样变性是其进展至ESRD的危险因素。
Objective:The aim of this study is to investigate the correlation of clinical and pathological features and their influences on the prognosis of the elderly patients with primary Ig A nephropathy.Methods:This study enrolled 87 patients aged≥60 with primary Ig A nephropathy and analyzed the clinical and pathological characteristic and follow-up data.Results:The average age of the patients was(64.9±3.9).The correlation analysis showed that the baselinee GFR was negatively related to the mesangial hypercellularity(M),tubular atrophy/interstitial fibrosis(T)and cellular/fibrocellular crescents(C).The baseline proteinuria was positively corelated to the mesangial hypercellularity(M),tubular atrophy/interstitial fibrosis(T)and cellular/fibrocellular crescents(C).Multivariate COX regression analysis revealed that the baseline GFR(HR=0.246;95%CI 0.118~0.514),tubular atrophy/interstitial fibrosis(HR=35.087;95%CI 1.850~665.329),cellular/fibrocellular crescents(HR=8.061;95%CI 1.000~64.985),arterial hyalinosis(HR=9.231;95%CI 1.900~44.836)and global sclerosis ratio(HR=1.033;95%CI 1.002~1.065)were independent predictor of progression to ESRD in the elderly patients with Ig A nephropathy.Conclusion:The formation of crescent and arterial hyalinosis can significantly affect the progression to ESRD for the elderly patients with Ig A nephropathy.
作者
张琦
吴杰
段姝伟
孟金玲
刘述文
张雪光
夏园园
王思杨
蔡广研
陈香美
ZHANG Qi;WU Jie;DUAN Shuwei(Department of Nephrology,Chinese PLA General Hospital,Chinese PLA Institute of Nephrology,State Key Laboratory of Kidney Diseases,National Clinical Research Center for Kidney Diseases,Beijing,100853)
出处
《中国中西医结合肾病杂志》
2016年第4期307-311,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
国家科技支撑计划项目(No.2011BAI10B03
2013BAI09B05
2015BAI12B06)
"863"基金资助项目(No.2012AA02A512)
"973"计划项目(No.2013CB530800)
关键词
IgA肾病
老年
临床病理
特点预后
IgA nephropathy
Elderly
Clinicopathological feature
Risk factors
