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原发性IgA肾病患者牛津分类、IgM沉积与多项指标之间的关系及不良预后相关危险因素分析

Analysis of the relationship between Oxford classification, IgM deposition and multiple indexes and the adverse prognosis of patients with primary IgA nephropathy and related risk factors.

作者信息

Hao Yan, Zhao Yuliang, Huang Rongshuang, Fu Ping

机构信息

Division of Nephrology, Kidney Research Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, P.R. China.

出版信息

Exp Ther Med. 2019 Feb;17(2):1234-1239. doi: 10.3892/etm.2018.7050. Epub 2018 Dec 5.

Abstract

The risk and influencing factors of prognosis in patients with primary IgA nephropathy (IgAN) were explored. One hundred and twenty-four patients who were diagnosed with IgA nephropathy in West China Hospital of Sichuan University were selected as the study subjects. The baseline data were recorded. All patients were followed up for 3 years. Patients with poor prognosis were defined as poor prognosis group, and the patient with no adverse prognosis was defined as a good prognosis group during the follow-up period. The risk factors that may affect the prognosis of patients with IgAN were analyzed by single factor analysis. The influence of all factors that were statistically significant on the prognosis of the patients was further evaluated by multifactor Cox regression. The single factor analysis and multivariate Cox proportional hazard model showed that patients with 24 h urinary protein, pathological type, Oxford classification (T1+T2), Lee (grade IV) and mesangial IgM deposition were independent factors of patients, and the difference was statistically significant, their P-values were 0.041, 0.046, 0.037, 0.043, and 0.028, respectively. Patients with 24 h urinary protein, pathological type, Oxford classification (T1+T2), Lee (grade IV) and mesangial IgM deposition can be used as independent factors affecting poor prognosis in primary IgAN patients. It provides evidence for early detection of high-risk IgA nephropathy.

摘要

探讨原发性IgA肾病(IgAN)患者预后的风险及影响因素。选取四川大学华西医院确诊为IgA肾病的124例患者作为研究对象,记录其基线资料。所有患者随访3年,随访期间将预后差的患者定义为预后差组,无不良预后的患者定义为预后好组。通过单因素分析分析可能影响IgAN患者预后的危险因素,对所有有统计学意义的因素对患者预后的影响进一步采用多因素Cox回归进行评估。单因素分析和多因素Cox比例风险模型显示,24小时尿蛋白、病理类型、牛津分类(T1+T2)、Lee(IV级)和系膜IgM沉积是患者的独立因素,差异有统计学意义,其P值分别为0.041、0.046、0.037、0.043和0.028。24小时尿蛋白、病理类型、牛津分类(T1+T2)、Lee(IV级)和系膜IgM沉积可作为影响原发性IgA肾病患者预后差的独立因素,为早期发现高危IgA肾病提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea15/6327417/a3ae94f57a6e/etm-17-02-1234-g00.jpg

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