临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (6): 410-.doi: 10.3969/j.issn.1000-3606.2020.06.003

• 泌尿系统疾病专栏 • 上一篇    下一篇

IgA 肾病患儿感染与血压及免疫指标的关联性

符庆瑛, 刘扬, 汪卫华, 罗开发, 张晓旭, 李建军, 陈光磊   

  1. 中国人民解放军联勤保障部队北戴河康复疗养中心肾脏病科(河北北戴河 066100)
  • 出版日期:2020-06-15 发布日期:2020-06-12
  • 通讯作者: 符庆瑛 电子信箱:fqykey@126.com

The relationship of infection with blood pressure and immunological indicators in children with IgA nephropathy

FU Qingying, LIU Yang, WANG Weihua, LUO Kaifa, ZHANG Xiaoxu, LI Jianjun, CHEN Guanglei   

  1. Department of Nephrology, Beidaihe Rehabilitation and Recuperation Center of PLA, Qinhuangdao 066100, Hebei, China
  • Online:2020-06-15 Published:2020-06-12

摘要: 目的 探讨IgA肾病(IgAN)患儿感染与血压及免疫指标的关联性。方法 收集2006年1月至2013年12月 经肾活检确诊的108例IgAN患儿的临床病理资料,根据起病前有否感染分为感染组(66例)和非感染组(42例),比较两 组患儿血压,血清免疫球蛋白、补体水平及肾组织免疫球蛋白、补体沉积强度。结果 与非感染组比较,感染组的肉眼血 尿比例较高,脉压较大,血清IgA、IgG水平较高,差异均有统计学意义(P<0.05)。 两组间肾组织IgM和补体C3沉积强度 分布差异均有统计学意义(P<0.05);IgM沉积强度阴性的比例较高,补体C3沉积强度为++的比例较高。感染与肉眼血尿、 脉压、血清IgA和IgG水平、肾组织补体C3沉积强度均呈正相关(P<0.05),与肾组织IgM沉积强度呈负相关(P<0.01)。 结论 IgAN儿童起病前常伴有感染,感染与脉压、血清IgA和IgG、肾组织IgM和补体C3沉积强度相关联,其变化特点对 儿童IgAN防治有指导意义。

关键词:  IgA肾病; 血压; 免疫球蛋白; 补体; 儿童

Abstract: Objective To explore the relationship of infection with blood pressure and immunological indicators in children with IgA nephropathy (IgAN). Methods The clinicopathological data of 108 children with IgAN diagnosed by renal biopsy from January 2006 to December 2013 were collected. The patients were divided into the infected group (66 cases) and the non-infected group (42 cases) depending on whether there was infection prior to the onset. Blood pressure, serum levels of immunoglobulin and complement, and the deposition intensity of immunoglobulin and complement in renal tissue were compared between the two groups. Results Compared with the non-infected group, the infected group had a higher proportion of gross hematuria, a greater pulse pressure, and higher serum IgA and IgG levels, and differences were statistically significant (P<0.05). There were statistically significant differences in the distribution of IgM and C3 deposition intensity in renal tissues between the two groups (P<0.05). The proportion of children with negative IgM deposition intensity was higher, and the proportion of children with C3 deposition intensity "++" was higher. Infection was positively correlated with gross hematuria, pulse pressure, serum IgA and IgG levels, and renal C3 deposition intensity (P<0.05), and negatively correlated with renal IgM deposition intensity (P<0.01). Conclusions IgAN is often accompanied by infection before the onset in children, and infection is associated with pulse pressure, serum IgA and IgG, and IgM and C3 deposition intensity in renal tissue. These characteristics are significant in guiding the prevention and treatment of IgAN in children.

Key words: IgA nephropathy; blood pressure; immunoglobulin; complement; child