西藏地区 IgA 肾病患者的临床与病理特征。
The clinical and pathological characteristics of IgA nephropathy patients in Tibet.
机构信息
Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.
Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China.
出版信息
BMC Nephrol. 2022 Jul 27;23(1):269. doi: 10.1186/s12882-022-02895-4.
BACKGROUND
There are few studies on immunoglobulin A nephropathy (IgAN) at high altitude. This study aimed to analyze the clinical and pathological characteristics of IgAN between Tibet and Beijing, which provided a basis for improving diagnosis and treatment in Tibet.
METHOD
The clinical and pathological data of 80 patients from the People's Hospital of Tibet Autonomous Region (Tibetan group) and 991 patients from Peking University First Hospital (Beijing group) with IgAN proven by renal biopsy were compared retrospectively between January 2016 and July 2020. The kidney biopsy tissue was sent to the Department of Nephrology, Peking University First Hospital for pathological evaluation.
RESULTS
The proteinuria (2.9 [2.0, 4.9] vs. 1.1 [0.5, 2.4] g/day, P < 0.001) in the Tibetan group was significantly higher than that in the Beijing group. The serum albumin (30.4 ± 7.7 vs. 38.2 ± 5.5 g/L, P < 0.001) was significantly lower in the Tibetan group. The eGFR (77.7 ± 37.8 vs. 62.1 ± 33.6 ml/min/1.73 m, P = 0.001) was higher in the Tibetan group. The percentage of patients with nephrotic syndrome in the Tibetan group was significantly higher than that in the Beijing group (33.8% vs. 4.7%, P < 0.001).
CONCLUSION
There are differences in the clinical and pathological characteristics of IgAN between plateau and plain regions.
背景
高海拔地区关于免疫球蛋白 A 肾病（IgAN）的研究较少。本研究旨在分析西藏和北京地区 IgAN 的临床和病理特点，为提高西藏地区的诊治水平提供依据。
方法
回顾性分析 2016 年 1 月至 2020 年 7 月西藏自治区人民医院（西藏组）80 例和北京大学第一医院（北京组）991 例经肾活检证实的 IgAN 患者的临床和病理资料，肾活检组织由北京大学第一医院肾病科进行病理评估。
结果
西藏组蛋白尿（2.9 [2.0，4.9]比 1.1 [0.5，2.4] g/d，P<0.001）显著高于北京组，血清白蛋白（30.4 ± 7.7 比 38.2 ± 5.5 g/L，P<0.001）显著低于北京组，估算的肾小球滤过率（77.7 ± 37.8 比 62.1 ± 33.6 ml/min/1.73 m，P=0.001）显著高于北京组。西藏组肾病综合征患者比例显著高于北京组（33.8%比 4.7%，P<0.001）。
结论
高原和平原地区 IgAN 的临床和病理特点存在差异。
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