IgA 肾病（IgAN）患者心血管疾病（CVD）患病情况及其相关危险因素分析

摘要

目的：探讨 IgA 肾病（IgA nephropathy ，IgAN）患者心血管疾病（Cardiovascular Disease，CVD）患病情况及其相关危险因素，为针对性预防与控制 IgAN 患者发生心血管并发症提供依据。方法选择2010年1月—2014年12月新疆医科大学第五附属医院肾内科住院及门诊随访的 IgAN 患者为研究对象，根据有无心血管疾病分为 CVD 组和非 CVD 组，比较两组患者一般临床资料和实验室检查结果，分析 IgAN 患者心血管疾病危险因素。结果IgAN 患者慢性肾脏病（Chronic kidney disease，CKD）5期患者心血管疾病发病率最高，发病率最高的心血管疾病为左心室肥厚。单因素分析结果发现：CVD 组患者吸烟者比例、BMI、血清肌酐、低密度脂蛋白、尿蛋白水平高于非 CVD 组患者，血红蛋白水平低于非 CVD 组患者（P ＜0．05）。多因素分析结果发现：IgAN 患者心血管疾病的危险因素为吸烟、血清肌酐升高、血红蛋白下降及低密度脂蛋白升高（P ＜0．05）。结论IgAN 患者心血管疾病的危险因素既包括吸烟、低密度脂蛋白升高等传统心血管疾病危险因素，也包括血清肌酐升高、血红蛋白下降等非传统心血管疾病危险因素。%Objective To investigate the prevalence and risk factors of cardiovascular disease (CVD)in pa-tients with IgA nephropathy,and to provide evidence for the prevention and control of cardiovascular com-plications in patients with IgA nephropathy.Method IgA nephropathy patients were collected from Janu-ary 2010 to December 2014 from the Fifth Affiliated Hospital of Xinjiang Medical University and outpa-tients follow-up from January 2010 to December 2014.The patients were divided into CVD group and non CVD group according to whether they have cardiovascular disease.The general clinical data and laboratory test results of two groups were compared to analyze the risk factors of cardiovascular disease in patients with IgA nephropathy.Results The incidence of cardiovascular disease in IgA nephropathy patients with the fifth stage chronic kidney disease was the highest,and the highest incidence rate was left ventricular hypertrophy.Single factor analysis showed that the proportion of smoking,BMI,serum creatinine,low density lipoprotein,urine protein level in CVD group was higher than non CVD group,while the hemoglo-bin level was lower than non CVD group (P <0.05).Multivariate analysis showed that the risk factors of cardiovascular disease in patients with IgA nephropathy were smoking,high serum creatinine,and low density lipoprotein increased and hemoglobin decreased (P <0.05).Conclusion The risk factors of cardio-vascular disease in patients with IgA nephropathy include both smoking and low density lipoprotein in-creased ,also include serum creatinine increased,hemoglobin decline and other non traditional cardiovascu-lar risk factors.