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强直性脊柱炎继发IgA肾病与原发性IgA肾病的对比研究

[A comparative study of IgA nephropathy secondary to ankylosing spondylitis and primary IgA nephropathy].

作者信息

Zhang Jie, Huang Feng, Zhang Jianglin

机构信息

Department of Rheumatology, PLA General Hospital, Beijing 100853, China.

Department of Rheumatology, PLA General Hospital, Beijing 100853, China; Email:

出版信息

Zhonghua Nei Ke Za Zhi. 2015 Dec;54(12):1032-6.

Abstract

OBJECTIVE

To study the characteristics of IgA nephropathy (IgAN) secondary to ankylosing spondylitis (AS) compared with primary IgAN.

METHODS

Clinical and pathologic data were collected in patients who were diagnosed with IgAN by renal biopsy and admitted to our hospital from Jan 2007 to Sep 2015. Patients with IgAN secondary to AS were recruited by the ratio 1:5 of patients with primary IgAN as control group at the same period.

RESULTS

There were 15 patients in AS group, proportionately 75 patients in the control group. Compared with those in control group, patients in AS group had shorter disease course [(10.1±8.3) months vs (20.2±27.9) months] and lower proportions of renal insufficiency and hypertension[1/15 vs 52.0%(39/75); 1/15 vs 46.7%(35/75)]. In laboratory tests, quantitative 24 hour urinary protein and serum creatinine were significantly lower in group AS than those in the control group [(1.42±0.67)g vs (2.88±1.35)g; (79.0±18.2)mmol/L vs (145.3±77.6) mmol/L]. The Lee grading of IgAN in two groups was comparable. The treatment in both groups was similar including steroids, immunosuppression agents, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers . After follow-up from 1 to 6 years, 3/11 patients in AS group and 22.8%(13/57)(13/75) in control group developed deterioration of renal function.

CONCLUSION

Patients with IgAN secondary to AS have shorter disease course and milder condition compared with patients with primary IgAN. Clinical outcome of renal function in both groups is similar according to comparable treatment.

摘要

目的

研究强直性脊柱炎(AS)继发IgA肾病(IgAN)相较于原发性IgAN的特点。

方法

收集2007年1月至2015年9月期间因肾活检确诊为IgAN并入住我院的患者的临床和病理资料。以1:5的比例选取同期原发性IgAN患者作为对照组,招募AS继发IgAN患者。

结果

AS组有15例患者,对照组相应有75例患者。与对照组相比,AS组患者病程较短[(10.1±8.3)个月 vs (20.2±27.9)个月],肾功能不全和高血压的比例较低[1/15 vs 52.0%(39/75);1/15 vs 46.7%(35/75)]。实验室检查中,AS组24小时尿蛋白定量和血清肌酐显著低于对照组[(1.42±0.67)g vs (2.88±1.35)g;(79.0±18.2)mmol/L vs (145.3±77.6)mmol/L]。两组IgAN的Lee分级相当。两组治疗相似,包括使用类固醇、免疫抑制剂、血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂。随访1至6年后,AS组11例患者中有3例、对照组22.8%(13/57)(13/75)出现肾功能恶化。

结论

与原发性IgAN患者相比,AS继发IgAN患者病程较短,病情较轻。根据相似的治疗,两组肾功能的临床结局相似。

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