| Objective:To explore the correlation between clinical indexes and pathologicalfeatures of IgA nephropathy patients in our hospitalMethods:Retrospective analysis was used.General data,laboratory indexes and renal pathological reports of patients diagnosed with IgA nephropathy in our hospital from January 2016 to September 2018 were collected.BMI was calculated and eGFR was estimated.Patients were grouped according to clinical and pathological characteristics.T test,one-way anova,k-s test,mann-whitney test,kruskal-wallis test and chi-square test were used for data analysis.Results:(1)Included were 137 patients average aged of 37.85±12.335 years.The ratio of male to female was 1:1.18.The major clinical symptoms is Asymptomatic hematuria and/or proteinuria(46.72%).The major pathologic types is Mesangial proliferative glomerulonephritis(84.67%).(2)The more severe the renal pathology Lee grading is,the lower the eGFR is,and the higher the urea nitrogen,serum creatinine,24h urinary protein and 24h urinary microalbumin are.(3)In the E1 group,the hemoglobin and serum albumin were lower than those in the E0 group,and the 24h urinary protein,24h urinary microalbumin and urinary erythrocyte were higher than those in the E0 group.The eGFR of group S1 was lower than that of group SO.In T1 group,urea nitrogen,serum creatinine,serum uric acid,24h urinary protein,24h uric microalbumin were higher than TO group,and eGFR was lower than TO group.(4)Age,BMI,urea nitrogen,serum creatinine and uric acid were higher in the hypertension group than in the non-hypertension group,while eGFR and urinary erythrocytes were lower in the hypertension group than in the non-hypertension group;Patients in the hypertension group had more severe Lee grading than those in the non-hypertension group.(5)BMI,hemoglobin,albumin,urea nitrogen,creatinine and uric acid were higher in male patients than in female patients,while HDL,eGFR and urinary red blood cells were lower in female patients.(6)Age,serum creatinine and eGFR were higher in patients with IgA elevation than those with normal IgA,and lower in patients with IgA elevation than those with normal IgA.Conclusion:IgAN patients with hypertension,high levels of serum creatinine,urea nitrogen,serum uric acid,24-hour urinary protein,24-hour urinary microalbumin and low levels of eGFR,albumin and hemoglobin may indicate more serious pathological grading,which can be used as a reference index for clinical judgment of pathological damage.Objective:More and more studies have found that mycophenolate mofetil(MMF)can be used to treat IgA nephropathy(IgAN).The efficacy and safety of MMF for IgAN remains debatable.the efficacy and safety of MMF treatment were systematically evaluated to provide a basis for clinical treatmentMethods:Databases including EMBASE/MEDLINE,PubMed,The Cochrane Library,CNKI and WanFang were searched from 1997 to 2018.The quality of the included studies was assessed,data were extracted and then meta-analysis was conducted using RevMan 5.3 soft ware.Results:A total of 13 RCTs and 1 CCT with nine publications(n=736 patients)were included.The results of meta-analyses showed that:(1)There were no significant differences in the overall effective rate(RR,1.87;95%CI,1.20-2.91;P--0.006)between the MMF group and the hormone group,placebo group.(2)There were significant difference in the overall effective rate(RR,1.41;95%CI,1.22-1.63;P<0.00001)between the MMF+hormone group and the hormone group,other immunosuppressants+hormone group.(3)There were no significant differences in the increased serum creatinine 50%rate(RR,2.56;95%CI,0.68-9.58;P-0.16)between the MMF group,MMF+hormone group and the hormone group,placebo group,other immunosuppressants+hormone group.(4)There were no significant differences in the end stage renal disease(ESRD)of patients with IgAN(RR,1.36;95%CI,0.46-4.00;P=0.58)between the MMF group,MMF+hormone group and the hormone group,placebo group,other immunosuppressants+hormone group.(5)The overall incidence rate of adverse reaction in the MMF group was high than the hormone group,placebo group(RR,3.19;95%CI,1.10-9.26;P=0.03).There were no significant differences in the overall incidence rate of adverse reaction(RR,0.52;95%CI,0.24-1.10;P=0.09)between the MMF+hormone group and the hormone group,other immunosuppressants+hormone group.Conclusion:MMF and MMF combined with hormone in treating IgAN can increase the overall eff ective rate and not increased risk of serum creatinine elevation or ESRD.MMF combined with hormone not increased the overall incidence rate of adverse reaction.but its effectiveness of improving long-term survival rate has to be further proved by conducting more high-quality,multi-center and large-scale clinical trials. |
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