基于"肾络癥瘕"探讨800例过敏性紫癜性肾炎儿童肾脏微观血瘀证与肾脏病理分级及相关理化指标的关系
The relationship between microscopic pattern of blood stasis and renal pathological grade and related physical and chemical indexes in 800 children with Henoch-Schönlein purpura nephritis based on"zhengjia in the kidney collateral"
摘要
Abstract
Objective We aimed to investigate the relationship between microscopic pattern of blood stasis and renal pathological grade and related physical and chemical indexes in children with Henoch-Schönlein purpura nephritis(HSPN).Methods We conducted a retrospective analysis of 800 HSPN children from the medical records of the First Affiliated Hospital of Henan University of Chinese Medicine.Laboratory indicators(blood routine test,urine routine test,coagulation test,liver function)and renal pathological indicators of them were collected.According to the severity of renal pathological microscopic lesions,the microscopic pattern of blood stasis was divided into three types,including choroidal discord,dead blood coagulation and intracarenal disease accumulation.The classification of renal microscopic pattern of blood stasis and the correlation between laboratory indexes and renal pathological index were analyzed by Spearman grade correlation and binary Logistic regression analysis.Results(ⅰ)There was no statistical difference of the distribution of the renal microscopic pattern of blood stasis in the different traditional Chinese medicine patterns.(ⅱ)There were significant differences in the contents or the grade of albumin and fibrinogen in the HSPN children with different microscopic pattern of blood stasis(all P＜0.05).(ⅲ)The maximum area under the receiver operating characteristic(ROC)curve between fibrinogen and intracarenal disease accumulation was 0.594(95％CI from 0.540 to 0.633,P＜0.001);sensitivity was 0.447,specificity was 0.725;the best threshold on the ROC curve of 0.172 was 3.755 g/L.(ⅳ)There were positive correlations between the content of fibrinogen,ISKDC grade and Bohle A grade respectively with the scores of intracarenal disease accumulation type(r=0.176,r=0.315,r=0.656;all P＜0.001).(ⅴ)There were positive correlations between the content of fibrinogen,ISKDC grade and Bohle A grade respectively with the renal microscopic pattern of blood stasis(r=0.157,r=0.377,r=0.429;all P＜0.001).Conclusion The microscopic renal pattern of blood stasis can not only reflect the severity of renal blood stasis,but also reflect the severity and long-term prognosis of renal diseases.Albumin and urinary protein grade can reflect the early stage of the microscopic renal pattern of the blood stasis(choroidal discord).The content of fibrinogen increases with the aggravation of renal microscopic pattern of blood stasis,reflecting the end-stage of HSPN,which has the correlation with the formation and severity of related indexes.Fibrinogen can be used as a laboratory indicator to assist in the diagnosis of irreversible lesionsin the renal pathology of HSPN children.关键词
过敏性紫癜性肾炎/病理分级/凝血指标/血瘀/纤维蛋白原Key words
Henoch-Schönlein purpura nephritis/pathological grade/coagulation index/blood stasis/fibrinogen分类
医药卫生引用本文复制引用
高敏,徐闪闪,丁樱,吴瑞红,任献青,徐炎,韩姗姗,代彦林,黄岩杰,杨晓青..基于"肾络癥瘕"探讨800例过敏性紫癜性肾炎儿童肾脏微观血瘀证与肾脏病理分级及相关理化指标的关系[J].北京中医药大学学报,2024,47(1):97-106,10.基金项目
国家自然科学基金青年科学基金项目(No.82305311,No.82305310) （No.82305311,No.82305310）
国医大师工作室建设项目(国中医药人教发[2022]245号) （国中医药人教发[2022]245号）
河南省博士后基金(No.HN2022096) （No.HN2022096）
河南省特色骨干学科中医学第二批学科建设项目(No.STG-ZYX05-202140) （No.STG-ZYX05-202140）
河南省中医学"双一流"创建科学研究专项(No.HSRP-DFCTCM-2023-8-10)National Natural Science Foundation of China(Nos.82305311 and 82305310) （No.HSRP-DFCTCM-2023-8-10）
Construction Project of Traditional Chinese Medicine Master Studio(No.[2022]245) （No.[2022]245）
The Postdoctoral Fund of Henan Province(No.HN2022096) （No.HN2022096）
The Second Batch of Discipline Construction Project of Traditional Chinese Medicine in The Characteristic Key Discipline of Henan Province(No.STG-ZYX05-202140) （No.STG-ZYX05-202140）
Scientific Research Project of"Double First-Class"of Traditional Chinese Medicine in Henan Province(No.HSRP-DFCTCM-2023-8-10) （No.HSRP-DFCTCM-2023-8-10）
