文献类型：期刊文献

中文题名：IgA肾病中医邪实证候与靶器官病理特征的相关性研究

英文题名：Correlation Study on Pathological Characteristics of Target Organs and Excess Evil Syndrome in IgA Nephropathy

作者：万廷信[1];戴恩来[2];王文革[3];刘天喜[4];刘沨[5];李银霞[1];姜敏[1];赵著华[1];杨百泉[6]

第一作者：万廷信

机构：[1]甘肃省武威市人民医院肾内科,甘肃733000;[2]甘肃中医药大学巾西医结合系,兰州730000;[3]兰州大学第二医院肾病中心,兰州730000;[4]兰州大学第一医院肾内科,兰州730000;[5]兰州大学基础医学院病理研究所,兰州730000;[6]甘肃省武威市凉州医院肾内科,甘肃733000

第一机构：甘肃省武威市人民医院肾内科,甘肃733000

年份：2015

卷号：35

期号：9

起止页码：1044

中文期刊名：中国中西医结合杂志

外文期刊名：Chinese Journal of Integrated Traditional and Western Medicine

收录：MEDLINE(收录号：26591356);CSTPCD;;Scopus;北大核心:【北大核心2014】；CSCD:【CSCD2015_2016】；PubMed;

基金：甘肃卫生行业科研计划项目(No.GSWST2010-12);甘肃省中医药科学技术研究课题(No.GZK-2012-54)

语种：中文

中文关键词：IgA肾病;邪实证候;肾脏病理

外文关键词：IgA nephropathy; excess evil syndrome; renal pathology

摘要：目的探讨IgA肾病中医邪实证候与肾脏靶器官病理之间的关系。方法采用多中心协作的研究方法收集数据,将266例IgA肾病患者根据中医辨证分型标准分为外感风热证(49例)、下焦湿热证(100例)、痰湿证(43例)和血瘀证(74例),各证型同时行肾穿刺活检病理诊断,进行Hass分级、牛津分类、Katafuchi积分和蒋氏评分,分析中医邪实证候与病理指数的关系。结果各证候与Hass分级具有相关性(r=0.341,P<0.01)。外感风热证与内皮细胞节段性增生及破坏毛细血管袢节段活动性病变具有关联性;下焦湿热证与HassⅢ级、破坏毛细血管袢节段活动性病变(高评分)、内皮细胞节段性增生、肾小球节段病变、局灶性间质炎性细胞浸润、局灶性间质纤维化及小管萎缩具有关联性;血瘀证与HassⅣ级、肾小球球性硬化、肾小球节段性硬化/黏连(segmental glomerulosclerosis,S)、系膜增生(mesangial hypercellularity,M)、血管透明变性、多灶状间质炎性细胞浸润、多灶状间质纤维化及小管萎缩具有关联性;痰湿证以Ⅰ和Ⅲ级为主,但与其他病理参数无关联性。结论中医邪实证候与IgA肾病部分病理特征具有相关性,邪实证候一定程度上可以反映IgA肾病靶器官病理损害程度、活动性与慢性病变及预后,相关病理特征及其发展变化可以提示中医邪实证候类型及其演变规律。
Objective To explore the correlation between pathological characteristics of target organs and excess evil syndrome in IgA nephropathy.Methods Data were collected in multicenter cooperation.Totally 266 IgA nephropathy patients were typed into exogenous wind-heat affection syndrome（49 cases）,lower energizer damp-heat syndrome（100 cases）,damp-phlegm syndrome（43 cases）,and blood stasis syndrome（74 cases）.Meanwhile,percutaneous renal biopsy was performed in all patients for Hass classification,Oxford classification,Katafuchi integral,and Jiang＇s classification methods.The correlation between excess evil syndrome and pathological index was analyzed.Results Four syndrome types were correlated with their Hass levels（r=0.341,P0.01）.Affection of exogenous wind-heat syndrome was correlated with segmental proliferation of endothelial cells and damaged active lesions of segmental capillary loops.Lower-energizer damp-heat syndrome was associated with Hass Ⅲlevel,destroying active lesions of capillary loops,segmental proliferation of endothelial cells,glomerular segmental lesions,focal interstitial infiltration of inflammatory cells,focal interstitial fibrosis and tubular atrophy.Blood stasis syndrome was associated with Hass Ⅳ level,glomerular sclerosis,segmental glomerulosclerosis（S）/adhesion,mesangial hypercellularity（M）,angiohyalinosis,multi-foci interstitial infiltration of inflammatory cells,multi-foci interstitial fibrosis and tubular atrophy.Phlegm-damp syndrome had higher proportions of Hass Ⅰ and Ⅲ levels,but with no association with other pathological parameters.Conclusions Excess evil syndrome was associated with partial pathological characteristics of IgA nephropathy.It could reflect pathological damage degree of target organs,activities,chronic lesions,and prognosis of IgA nephropathy to certain extent.Correlated pathological characteristics and its evolution could indicate excess evil syndrome types and their evolution rules.