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目的:探讨狼疮性肾炎(lupus nephritis,LN)患者高尿酸血症与肾损伤的关系。方法:回顾性分析经肾病理活检证实的177例LN患者,比较正常尿酸组和高尿酸血症组患者的临床特点、实验室检查和肾病理的差别,分析血清尿酸水平与肾损伤相关指标的关系。结果:LN合并高尿酸血症组的高血压发生率、血清尿素氮及血清肌酐水平较正常尿酸组显著升高(P<0.01),而估算的肾小球滤过率(estimated glomerular filtration rate,e GFR)、抗U1RNP抗体阳性率较正常尿酸组显著降低(P<0.01);高尿酸血症组患者的肾病理损伤评分(活动性指数、慢性化指数、肾小管间质损伤指数)均明显高于正常尿酸组(P<0.05);LN患者血清尿酸水平与血清肌酐、肾病理分型和肾病理损伤评分均呈正相关,与e GFR呈负相关(P<0.01)。结论:合并高尿酸血症的LN患者肾损伤较重,高尿酸血症是狼疮性肾炎患者预后不良的重要指标之一。
Objective: To investigate the relationship between hyperuricemia and renal damage in patients with lupus nephritis (LN). Methods: A total of 177 LN patients confirmed by renal biopsy were retrospectively analyzed. The clinical features, laboratory tests and pathological changes were compared between normal uric acid group and hyperuricemia group. The levels of serum uric acid and renal injury were analyzed relationship. Results: The incidence of hypertension, serum urea nitrogen and serum creatinine in patients with LN combined hyperuricemia were significantly higher than those in patients with normal uric acid (P <0.01), while the estimated glomerular filtration rate e GFR). The positive rate of anti-U1RNP antibody was significantly lower than that of normal uric acid group (P <0.01). The renal pathological damage scores (activity index, chronic index and tubulointerstitial injury index) of patients with hyperuricemia were significantly (P <0.05). Serum uric acid levels in patients with LN were positively correlated with serum creatinine, nephridial pathological type and pathological damage index, and negatively correlated with eGFR (P <0.01). Conclusion: LN patients with hyperuricemia have severe renal injury and hyperuricemia is one of the most important prognostic factors in patients with lupus nephritis.