| Objective:To analyze the clinical,pathological and laboratory biochemical indexes of 111 patients with primary Ig A nephropathy diagnosed in our hospital.The clinical and pathological characteristics and correlations were analyzed systematically.The incidence and clinical characteristics of the disease were analyzed.Relevance,for my area of primary Ig A nephropathy to provide epidemiological data for the diagnosis and treatment of the disease and provide a theoretical basis.Methods:Retrospective analysis from June 2011 to January 2017 in Yan'an University Affiliated Hospital Nephrology confirmed the diagnosis of primary Ig A nephropathy in 111 cases.Collect all patients with general clinical data,pathology,laboratory data.Pathological grading was performed by Lee SMK pathological grading method to analyze the clinical characteristics of Ig A nephropathy and its relationship with pathological changes.All data were analyzed by SPSS 20.0 software.Result: 1.Ig A nephropathy in general data analysis results(1)General information: 58 cases of male patients,53 cases of female patients,male and female ratio of 1.1: 1,the age of onset 11 to 71 years old,the average age of onset 35.82±13.09 years;the course of disease 3 days to 300 months,the average course of disease 30.50±56.11 months.111 patients(38.4%),workers(27.3%),residents(13.51%),students(9.01%),cadres(7.21%),teachers(4.5%).(2)Clinical and pathological stage characteristics: CKD stage 1 patients 66 cases(59.46%),stage 2 cases of 17 cases(25.23%),stage 3 cases of 15 cases(13.51%),stage 4 cases of 3 cases(2.7%),stage 5 cases of 10 cases(9.01%).Pathological grade Lee grade ?grade 0 cases,grade?37 cases(33.33%),grade ?44 cases(39.64%),grade ?23 cases(20.72%),grade?7 cases(6.31%).2.Ig A patients with nephropathy biochemical data analysis results(1)Age and blood pressure,triglyceride,cholesterol between the correlation:the older patientswith hypertension,renal insufficiency,hypertriglyceridemia,hypercholesterolemia significantly increased risk.(P values were <0.01,0.04,0.024,0.01,respectively)(2)24-hour urine protein quantitative characteristics:24-hour urine protein quantification<0.5g/d in patients with pathological grade to grade ?,?grade,accounting for 52.17%,39.1%,a large number of patients with proteinuria(>3.5g/d)in patients with pathological grade to grade or more,accounting for 60%.With the 24?-hour increase in urinary protein increased the pathological grading gradually increased,the difference between groups was statistically significant(?2=25.31,P=0.014).With the 24-hour increase in proteinuria,CKD staging was also significantly increased(?2=28.26,P <0.01).(3)Hematuria and clinical and pathological correlation between:The average incidence of hematuria in patients with non-hematuria was shorter(P = 0.02).The number of predecessor infections was higher than that of non-hematuria(P=0.034),Serum creatinine levels were lower in patients with non-hematuria(P=0.03).There was no significant difference in sex between the groups and the mean age of onset.There was no significant difference between hematuria group and non-hematuria group and CKD group(?2=6.26,P=0.174),the pathological grade of non-hematuria group was lower than that of hematuria group(?2=28.26,P <0.01).(4)The relationship between anemia and clinical and pathology: Significantly different between the anemia group and the non-anemia group(?2=9.86,P=0.016,?2= 31.77,P <0.001).(5)Relationship between serum uric acid level and clinical and pathologic:There was no significant difference in sex,mean age of onset,and plasma albumin in patients with hyperuricemia and nonadenoic acid.Hyperuricemia in patients with duration,triglycerides,total cholesterol were higher than nonhypertensive group.(?2=28.32,P <0.01,?2= 13.13,P = 0.003),and the scores of CKD were significantly higher in patients with hyperuricemia than those without hyperuricemia.There was no significant difference between hyperuricemia and nonhyly hyperuricemia(?2=7.41,P=0.104),the difference was not statistically significant.3.Conclusion(1)In Yan'an area,111 patients with primary Ig A nephropathy accounted for 17.5% of the renal biopsy in the same period.The peak age was 21 to 29 years(36%).(38.4%),followed by workers(27.3%).(2)Symptoms of various symptoms,urine and physical examination abnormalities,edema more common,accounting for 39.64%,respectively,30.63%.(3)CKD1 accounted for the highest proportion of 59.46%,pathology to Lee SMK ? grade,grade more common,accounting for 33.33%,39.64%,class 0 cases.? ?(4)Pathological grade increased with the progression of CKD stage,P <0.001,with significant difference.(5)Age was positively correlated with hypertension,impaired renal function and hypertriglyceridemia,but had no significant correlation with hypercholesterolemia.(6)Proteinuria and CKD staging was positively correlated,and with proteinuria increased,more than the proportion of pathological grade ?.(7)The average incidence of Ig A combined with hematuria was significantly lower than that of non-hematuria group,and the number of hematuria group was significantly higher than that of non-hematuria group,Accounting for the proportion gradually increased.(8)With the pathological grade increased,the incidence of anemia gradually increased.(9)Patients with duration,blood pressure,cholesterol and triglycerides and hyperuricemia was positively correlated with the CKD stage and pathological grade increased,the incidence of hyperuricemia gradually increased. |
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