| Objective:Through cross-sectional retrospective analysis,the general data of patients with chronic persistent primary IgA nephropathy hematuria with mild proteinuria,TCM syndrome,clinical indicators,renal pathological grade were summarized,in order to provide relevant reference for the clinical evaluation of this type of IgA nephropathy and the prevention and treatment of integrated Traditional Chinese and Western medicine.Methods:Collect primary IgA nephropathy treated in the diagnosis and treatment center of nephropathy of Tianjin TCM Institute from September 2019 to January 2022,and screened according to the diagnostic criteria,inclusion criteria and exclusion criteria.Finally,82 qualified cases were obtained.Excel software was used to establish a database and enter relevant information,including name,age,gender,current symptoms,body mass index,tongue and pulse,mode of first onset,previous macroscopic hematuria At present,the status of mucosal infection(chronic upper respiratory tract infection,chronic urinary tract infection,chronic gastrointestinal tract infection,etc.),laboratory indexes(urinary red blood cell count,serum albumin,hemoglobin,platelets,fibrinogen,total cholesterol,triglyceride,renal function,serum immune protein,etc.),TCM syndrome,Lee’s classification of renal pathology,and then spss24 0 software to analyze and process the collected data,analyze the population distribution characteristics of patients with chronic persistent IgA nephropathy hematuria with mild proteinuria,and the correlation between hematuria,proteinuria and general data,clinical indicators,TCM syndromes,pathological grades,etc.Result:1.General data: Of the 82 patients with primary IgA nephropathy,Male patients were included in 46.34%,Women accounted for 53.66%,Male: female =1:1.16;The mean age of onset was 37.22 ± 12.54 years,The minimum age of onset was 16 years,The maximum age of onset was 65 years old,Among them,the number of people aged 20-40 years accounted for62.20%;The maximum number of patients was 32.93% within 1 year;The mean BMI was24.26±2.69kg/m2,The highest BMI was 32 kg/m2,The lowest body mass index was 17kg/m2,The most overweight people accounted for 58.54%;Physical examination accounted for 65.85% of the cases,Secondly,the above respiratory tract infection is mainly caused,Clinical discomfort symptoms are low back pain,foam urine,etc.;With hematuria at the first visit,microscopic hematuria accounted for 79.27%;A previous history of gross hematuria accounted for 29.27%;The existing mucosal infection status accounted for 47.56%,Among them,the mucosal infection is mainly chronic pharyngitis and chronic tonsillitis.2.Clinical indicators: The number of hematuria grade 2 was the most,accounting for43.90%;The number of urinary occult blood 3 + was the most,accounting for 41.46%;The number of 24-hour urinary protein quantitative grade 2 was the most,accounting for 57.32%;Ckd1 has the largest number,accounting for 41.46%.The 24-hour urinary protein quantity increased with hematuria grade.The 24-hour urinary protein quantity of hematuria grade 1was lower than that of hematuria grade 2 and hematuria grade 3,and there was significant difference between the groups(P<0.01);There was a positive correlation between hematuria grade and 24-hour urinary protein quantitative grade(P < 0.01);There was no correlation between hematuria grade and 24-hour urinary protein quantitative grade and 2ckd stage(P >0.05);There was a positive correlation between urinary erythrocyte count and 24-hour urinary protein(P<0.01).3.Relationship between clinical indexes and general data: There was a negative correlation between urinary red blood cell count and age of onset(P<0.05);The average level of urinary red blood cell count in the group with existing mucosal infection was higher than that in the group without mucosal infection(P<0.05);The average level of urinary red blood cell count in the group with previous history of gross hematuria was higher than that in the group without history of gross hematuria(P>0.05).4.TCM syndrome analysis: In this deficiency syndrome,Qi and yin deficiency syndrome accounted for 31.71%;The number of damp heat syndrome was the most,accounting for 37.80%;In this deficiency syndrome,the urinary red blood cell count of lung spleen qi deficiency syndrome was the highest,and that of blood stasis syndrome was the highest.There was no significant difference in the distribution of urinary red blood cell count between this deficiency syndrome and concurrent syndrome(P > 0.05);There was no significant difference in the distribution of hematuria grade between this deficiency syndrome and concurrent syndrome(P>0.05).5.Pathological analysis of kidney: In this study,grade II(37.80%)and grade III(34.15%)accounted for the majority of Lee’s grading of renal pathology;The urinary red blood cell count in Lee’s grade III was higher than that in Lee’s grade I(P<0.01),that in Lee’s grade IV and Lee’s grade V was higher than that in Lee’s grade I(P<0.05),and that in Lee’s grade III and Lee’s grade IV was higher than that in Lee’s grade II(P<0.05);Hematuria grade was positively correlated with Lee’s grade(P<0.01);There was no significant difference in the distribution of gross hematuria history in different Lee’s grades(P > 0.05).The 24-hour urinary protein quantification in Lee’s grade I-V showed an increasing trend,and the 24-hour urinary protein quantification in Lee’s grade III,Lee’s grade IV and Lee’s grade V was higher than that in Lee’s grade I(P<0.05);The 24-hour urinary protein of Lee’s grade III and Lee’s grade IV was higher than that of Lee’s grade II(P < 0.05).Lee’s grade was positively correlated with the quantitative grade of 24-hour urinary protein(P<0.01).There was no significant difference in the distribution of this deficiency syndrome in different Lee’s grades(P>0.05).There was no significant difference in the distribution of concurrent syndrome types in different Lee’s grades(P > 0.05).Conclusion:1.The degree of hematuria in IgA nephropathy was consistent with the degree of proteinuria in this study.Hematuria should be actively treated in the clinic.2.The hematuria degree of IgA nephropathy was inversely associated with age of onset in this study,and attention should be paid to intervention in younger patients.3.Mucosal infection can aggravate the hematuria condition of patients with IgA nephropathy,and the mucosal infection should be actively prevented and treated.4.The degree of hematuria and urinary protein in patients with IgA nephropathy were consistent with the renal pathological manifestations. |
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