伴有肾功能异常的IgA肾病患者高血压的发生特点及相关因素分析

摘要

目的 探讨伴有肾功能异常的IgA肾病患者高血压的发生特点及相关因素.方法 选取2005年1月至2015年12月经肾活检确诊为IgA肾病,且肾小球滤过率(eGFR)<50ml/(min·1.73m2)的患者103例,根据血压高低分为高血压组(87例)和血压正常组(16例),分析高血压与临床、病理各项指标的相关性.结果 伴有肾功能异常的IgA肾病患者高血压的发生率84.47%.单因素分析结果表明,年龄、性别、病程、高血压家族史、BMI、蛋白尿程度、高甘油三酯血症、高胆固醇血症、系膜增生程度、肾小球硬化率、新月体形成、肾小管间质病变及肾小动脉病变等因素与高血压的发生相关;多因素logistic回归分析结果表明,年龄≥45岁、高血压家族史、蛋白尿≥2g/d、BMI≥25、肾小球硬化率≥50%及肾小动脉病变是高血压发生的独立危险因素.结论 伴有肾功能异常的IgA肾病患者高血压的发生率高,其与年龄、蛋白尿程度、BMI、肾小球硬化率及肾小动脉病变等相关,提示对IgA肾病早期干预治疗十分重要.%Objective To study the clinical characteristics and the influencing factors of hypertension in IgA nephropathy(IgAN)patients with abnormal renal function.Methds From January 1,2005 to December 31,2015,a total of 103 idiopathic IgAN patients with abnormal renal function(eGFR<50ml/min)confirmed by renal biopsy were treated in the Department of Nephrology,Huzhou Municipal Central.The patients were divided into a hypertension group(n=87)and a normal group(n=16)according to the blood pressure(BP)level univariate and multivariate logistic regression analysis were used to analyze the relationship between the hypertension and clinical-pathological factors.ResultsThe incidence of hypertension in IgAN with abnormal renal function was 84.47%(87/103).Single-variable analysis showed that age(≥45 years),sex(male), course of disease(≥3 years),familial history of hypertension,Body Mass Index(BMI),degree of proteinuria(≥2g/d),hyperlipoidemia, hypercholesteremia,mesangial proliferation,glomerular sclerosis,crescent formation,degree of renal interstitial injury and renal arteriolar lesion all associated with the incidence of hypertension.Multivariate logistic regression analysis showed that the independent influencing factors for hypertension in patients of IgA nephropathy with abnormal renal fuction included age,familial history of hypertension,degree of proteinuria,BMI,glomerular sclerosis and renal arteriolar lesion.ConlusionThe incidence of hypertension in IgAN with abnormal renal function is high,and is associated with age,degree of proteinuria,BMI,glomerular sclerosis and renal arteriolar lesion.In order to lower the incidence of hypertension,early intervening treatment is very important.