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[免疫球蛋白A血管炎伴肾炎及高凝状态患儿的尿蛋白及肾脏病理特征]

[Urinary protein and renal pathological features in children with immunoglobulin A vasculitis with nephritis and hypercoagulability].

作者信息

Bai Meng-Ke, Yang Xiao-Qing, Mei Xiao-Feng, Li Jin-Gang, Yang Yue-Li, Huang Yan-Jie

机构信息

Pediatrics Hospital, First Affiliated Hospital of Henan University of Chinese Medicine/College of Pediatrics, Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China (Huang Y-J, Email: huangyanjie69@163. com).

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2024 Feb 15;26(2):164-168. doi: 10.7499/j.issn.1008-8830.2309033.

Abstract

OBJECTIVES

To study the association of hypercoagulability with urinary protein and renal pathological damage in children with immunoglobulin A vasculitis with nephritis (IgAVN).

METHODS

Based on the results of coagulation function, 349 children with IgAVN were divided into a hypercoagulability group consisting of 52 children and a non-hypercoagulability group consisting of 297 children. Urinary protein and renal pathological features were compared between the two groups, and the factors influencing the formation of hypercoagulability in children with IgAVN were analyzed.

RESULTS

Compared with the non-hypercoagulability group, the hypercoagulability group had significantly higher levels of urinary erythrocyte count, 24-hour urinary protein, urinary protein/creatinine, urinary immunoglobulin G/creatinine, and urinary N-acetyl-β-D-glucosaminidase (<0.05). The hypercoagulability group also had a significantly higher proportion of children with a renal pathological grade of III-IV, diffuse mesangial proliferation, capillary endothelial cell proliferation, or >25% crescent formation (<0.05). The multivariate logistic regression analysis showed that capillary endothelial cell proliferation and glomerular crescent formation >25% were associated with the formation of hypercoagulability in children with IgAVN (<0.05).

CONCLUSIONS

The renal injury in IgAVN children with hypercoagulability is more severe, with greater than 25% crescent formation and increased proliferation of glomerular endothelial cells being important contributing factors that exacerbate the hypercoagulable state in IgAVN.

摘要

目的

研究免疫球蛋白A血管炎伴肾炎(IgAVN)患儿高凝状态与尿蛋白及肾脏病理损伤的相关性。

方法

根据凝血功能结果,将349例IgAVN患儿分为高凝组52例和非高凝组297例。比较两组患儿的尿蛋白及肾脏病理特征,并分析影响IgAVN患儿高凝状态形成的因素。

结果

与非高凝组相比,高凝组患儿的尿红细胞计数、24小时尿蛋白、尿蛋白/肌酐、尿免疫球蛋白G/肌酐及尿N-乙酰-β-D-氨基葡萄糖苷酶水平显著更高(<0.05)。高凝组患儿肾脏病理分级为III-IV级、弥漫性系膜增生、毛细血管内皮细胞增生或新月体形成>25%的比例也显著更高(<0.05)。多因素logistic回归分析显示,毛细血管内皮细胞增生和肾小球新月体形成>25%与IgAVN患儿高凝状态的形成有关(<0.05)。

结论

IgAVN高凝患儿的肾脏损伤更严重,新月体形成>25%及肾小球内皮细胞增殖增加是加重IgAVN高凝状态的重要因素。

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