The Difference Of The Pathological Manifestations And TCM Syndrome In Adult IgA Nephropathy And Purpura Nephritis Characterized By Nephrotic Syndrome

Objective To explore pathological manifestations and TCM syndromes between Adult IgA nephropathy and allergic purpura nephritis with nephrotic syndrome.Methods 1.Research methods:This study used retrospective clinical research methods.2.Object of study: The patients were all hospitalized in our hospital and were diagnosed as IgA nephropathy(IgAN)and Henoch-Schonlein purpura nephritis(HSPN)respectively.Secondary IgA deposition caused by purpura nephritis,hepatitis B-related nephritis and systemic lupus erythematosus were excluded in IgAN group Of the disease,HSPN group excluded purpura-like rash with other diseases of kidney disease such as lupus nephritis and cryoglobulinemia.3.Research steps: Collect the data of the four methods of examination,related physical and chemical indexes,renal pathological in IgAN group and HSPN group,then conduct statistical analysis.Results 1.The urinary cell counts,glomerular filtration rate,high-sensitivity C-reactive protein,white blood cell count and neutrophil percentage in HSPN group were higher than those in IgAN group,but the levels of uric acid,LDL,cholesterol,Ig E,(P<0.05).There was no significant difference in the levels of creatinine,urea nitrogen and triglyceride between the two groups(P>0.05).The chronic nephritic staging of the two groups of diseases was found and HSPN Group CKD1 more patients than IgA group,IgAN group CKD2,CKD3,CKD4 more than HSPN group(P<0.05).2.In HSPN group showed nephrotic syndrome the score of glomerular integral and glomerular segment injury is higher than that in IgAN group(P<0.05),the incidence of crescent disease is higher than that of IgAN group(P<0.05),the difference was statistically significant,and there was no significant difference in the scores of renal interstitial and vascular lesions.The distribution intensity of Ig G and F in IgAN group was significantly higher than that in HSPN group(P<0.05).There was no significant difference in the sediments of other immune complexes and complement(P>0.05),and the deposition of C1 q was less in both groups,and the combined deposition of C4 was least.There was also no significant difference between the two groups in the type of immune complex deposition(P>0.05).There were more C3 deposition in IgAN group and HSPN group,which could be combined with other types of complement deposition,but the difference was not statistically significant(P>0.05).There was no significant difference between the two electron microscopy results(P>0.05).3.Statistical analysis of the two groups of TCM syndrome distribution,P=0.236,no statistical significance.Different syndromes compared with each other,the composition ratio was not statistically significant.The form ratio of TCM Syndrome Types in group IgAN was different(P<0.05),and rheumatic syndromes were the majority.There was no statistical significance in HSPN group(P>0.05).IgAN group of Kidney deficiency/Rheumatic syndrome,Blood stasis/Rheumatic syndrome,Liver wind /Rheumatic syndrome was more,HSPN group of kidney deficiency/blood stasis/ rheumatic arthralgia syndrome,Liver wind /kidney deficiency/rheumatism syndrome was more.The distribution of the syndrome is different between the two groups.Rheumatism/kidney deficiency/blood stasis syndrome was compared with Liver wind/rheumatism syndrome,liver wind/kidney deficiency/blood stasis syndrome was compared with that,the difference was statistically significant(P<0.05).The distribution of the other syndromes was not statistically significant in group of IgAN and HSPN.4.In the distribution of TCM syndromes in HSPN group rheumatic syndrome was mainly in stage of CKD1 and CKD2,liver wind syndrome was mainly in stage of CKD3,adulteration was mainly in stage of CKD4.Rheumatic syndrome was mainly in stage of CKD1,CKD2 and CKD3,adulteration was mainly in stage of CKD4 in group of IgAN(P<0.05).5.IgAN and HSPN glomerular integral no significant difference(P>0.05)in kidney deficiency and adulteration syndromes,however Glomerular segmental injury was statistically significant(P <0.05)in these syndromes.Glomerular integral and glomerular segment injury scores were not statistically different(P>0.05)in blood stasis syndrome.Glomerular integral and segment injury scores were statistically significant(P<0.05)in Rheumatic syndrome.There was a significant difference in glomerular scores between the two groups(P<0.05),while there was no significant difference in glomerular segment injury scores(P>0.05)in liver wind syndrome.Conclusion 1.Nephrotic syndrome as the main manifestation of adult IgA nephropathy and allergic purpura nephritis clinical symptoms vary greatly.HSPN was more predisposing factors,more acute onset,inflammation is higher,both serum creatinine levels similar,but overall renal dysfunction than IgAN.2.The nephrotic syndrome as the main manifestation of adult HSPN glomerular damage and glomerular segmental lesions was serious than IgAN,the incidence of crescent disease is higher than IgA nephropathy,and renal interstitial damage and vascular lesions are similar.3.In TCM syndromes,rheumatic / kidney deficiency syndrome was common in IgAN,it was merged by blood stasis and liver wind syndrome in HSPN.This is instructive for the treatment of both diseases.4.Glomerular damage in HSPN from rheumatic syndrome is more serious than that of IgAN;glomerular damage in IgAN from liver wind syndrome is more serious than that of HSPN.Renal disease segment damage in HSPN from kidney deficiency syndrome,rheumatic syndrome and adulteration is more serious than that of IgAN.