| Objective1.Using factor analysis and cluster analysis to study the characteristics of TCM syndromes of IgA nephropathy,and to provide objective basis for TCM syndrome differentiation of IgA nephropathy.2.To analyze the effect of fasting blood glucose and hemoglobin,serum creatinine,serum albumin,serum urea,serum uric acid,triglyceride,cholesterol,low density lipoprotein,high density lipoprotein(HDL)in different ages,urine protein,Urine red blood cell,immunofluorescence IgA,renal Hass grade,serum creatinine,serum albumin,serum urea,serum uric acid,triglyceride.We also want to know the risk factors of renal function decline in patients with IgA nephropathy.MethodsIn this study,a retrospective study was conducted to collect renal biopsy from February 2011 to December 2016 in Guangdong Provincial Hospital of traditional Chinese Medicine.The pathological findings were confirmed as IgA nephropathy,and the four diagnostic data,clinical indicators,and history of renal puncture were collected.Factor analysis of symptoms and tongue veins with high frequency,further cluster analysis,differentiation of TCM syndromes according to different syndromes,and study on different age,urine protein,urine red blood cell,IgA degree of immunofluorescence,The relationship between renal pathological Hass grade and clinical indexes and the risk factors of renal function decline during renal puncture in patients with IgA nephropathy were investigated.Results1.In the first diagnosis,there were 427 cases of IgA nephropathy,slightly more women,about 0.9 :1.0 in male and female.The average age was 34.37±11.451 years,20-40 years old,65.57%.The first diagnosis was chronic nephritis syndrome and chronic renal failure.Among them,there were 232 cases accounting for 54.32%.2.Research on TCM Syndrome based on Factor Analysis and Cluster Analysis: this study collected 42 common symptoms and signs of IgA nephropathy patients with KMO-KMO value was 0.725,> 0.7.in Bartlett spherical test,the approximate chi-square value was 12882.76 g P < 0.000,which was suitable for factor analysis.According to factor analysis,we can conclude that there are qi deficiency,yin deficiency,yang deficiency,damp-heat,wind-heat,and disease location with lung,spleen and kidney.According to cluster analysis,we can conclude that IgA nephropathy can be divided into 6 syndromes.It included: Qi and Yin deficiency syndrome(99 cases),Kidney Yin deficiency Syndrome(94 cases),liver and Kidney Yin deficiency Syndrome(101 cases),Yin deficiency Fire Syndrome(15 cases),spleen and Kidney Qi deficiency Syndrome(98 cases),spleen and Kidney Yang deficiency Syndrome(20 cases).3.Correlation result analysis:(1)The age and clinical indicators: compared to 0-20 years old,20-40 years old,40-60 years old of creatinine in patients with IgA nephropathy,and cholesterol level is higher;60-80 patients with IgA nephropathy,low albumin,urea,fasting blood glucose,triglyceride,low density lipoprotein,high density lipoprotein in different age groups of high uric acid,no differences in hemoglobin level.(2)Urinary protein and clinical indicators: urinary protein 3+-4+IgA nephropathy,creatinine,uric acid,urea,cholesterol,triglyceride,low density lipoprotein and hemoglobin were the lowest.There was no difference in the average level of high-density lipoprotein,fasting blood glucose and albumin for different urine protein levels.(3)Urine red blood cell and clinical indicators: Serum creatinine,serum albumin,serum urea,triglyceride,low density lipoprotein,high density lipoprotein,urinary protein in patients with IgA nephropathy of different degree had no significant difference,and there was no significant difference in serum creatinine,serum albumin,serum urea,triglyceride,low density lipoprotein,high density lipoprotein and urinary protein.The level of serum uric acid was the highest in negative-±group,the highest in group 1-2,and the lowest in group 3-4.(4)Glomerular pathology and clinical indexes: IgA immunofluorescence immunofluorescence with different degrees of IgA patients,the fasting blood glucose,creatinine,urea,albumin,low density lipoprotein,high density lipoprotein,no difference in hemoglobin level,glomerular pathology immunofluorescence group IgA+ the highest level of uric acid,glomerular pathology immunofluorescence IgA++ cholesterol group the highest level of glomerular pathology immunofluorescence IgA+ group triglyceride level is the highest.(5)The grade of HASS III was 39.8% in renal HASS grade of IgA nephropathy,which was the most common pathological grade of HASS.Serum creatinine,serum urea,serum uric acid,serum albumin and hemoglobin were different among different HASS pathological grade groups.(6)Serum creatinine,serum uric acid,serum urea level were the highest in renal pathological HASS V group.The level of hemoglobin was the lowest,cholesterol,fasting blood glucose,low density lipoprotein,high density lipoprotein and triglyceride had no difference among different Hass grading groups.The risk factors of renal function decline during renal puncture were analyzed by logistic regression analysis.The age,male,with hyperuricemia and low serum albumin grade HassIVV were the risk factors of renal function decline during renal puncture in IgA nephropathy.The risk of renal function decline in patients with hyperuricemia was 5.426 times higher than that in patients without hyperuricemia.Conclusion1.The most common onset age of IgA nephropathy was 20-40 years old.2.IgA nephropathy syndrome can be divided into qi and yin deficiency syndrome,kidney yin deficiency syndrome,liver and kidney yin deficiency syndrome,yin deficiency fire flourishing syndrome,spleen and kidney qi deficiency syndrome,spleen and kidney yang deficiency syndrome.3.For patients with IgA nephropathy,age,urinary protein quantification and pathological grade have certain relationship with renal function.The degree of urinary occult blood and immunofluorescence IgA had no significant effect on renal function,blood lipid,blood glucose and albumin.4.Hass III grade is one of the most common pathological types in the elderly.Male patients with hyperuricemia and low albumin grade V are the risk factors for renal function decline during renal puncture in IgA nephropathy. |
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