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| IgA肾病血管内皮损伤及其与中医证型相关性的临床研究 |
| Clinical study on relationship between injury of vascular endothelium and TCM syndromes in IgA nephropathy |
| 投稿时间：2022-12-08 修订日期：2022-12-08 |
| DOI： |
| 中文关键词: IgA肾病 血管损害 中医证型 |
| 英文关键词: IgA nephropathy Vascular damage TCM Syndrome Type. |
| 基金项目:浙江省自然科学基于 HB-EGF/EGFR研究三七总皂苷对 IgA肾病肾小血管病变的保护机制,编号:LY17H290003。 |
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| 中文摘要: |
| 摘要：目的:探讨IgA肾病血管内皮损伤及其与中医证型相关性，为IgA肾病中医辨证提供更为精准微观辨证依据。方法:原发性IgA肾病患者59例，中医辨证分型，健康对照19例，用ELISA法检测。结果:IgA肾病患者vWF、sVCAM-1和HB-EGF水平高于健康对照组（P<0.01），血sVCAM-1与HB-EGF呈正相关（P<0.05）；血sVCAM-1与24小时尿蛋白、尿红细胞计数、凝血功能呈正相关（P<0.05）。中医证型分布多为虚实兼夹，以脾肾阳虚证组vWF、sVCAM-1、HB-EGF升高最明显, 血瘀证组高于非血瘀证组（P<0.01）。血vWF、sVCAM-1、HB-EGF对IgA肾病血瘀证均具有良好的敏感性和特异性。结论:IgA肾病患者存在严重的炎症性血管内皮损伤，且与临床病情程度相关；脾肾阳虚证、血瘀证患者血管内皮损害更严重。血vWF、sVCAM-1、HB-EGF对临床判断病情及指导治疗具有积极意义。 |
| 英文摘要: |
| Abstract Objective The relationship between vascular endothelial injury and TCM Syndrome Types in IgA nephropathy were explored to provide more accurate microscopic evidence for TCM syndrome differentiation. Methods 59 patients with primary IgA nephropathy were classified according to TCM syndrome differentiation. 19 healthy normal people were selected. The levels of vWF, sVCAM-1 and HB-EGF were detected by ELISA. Results The levels of vWF, sVCAM-1 and HB-EGF in patients with IgA nephropathy were higher than those in healthy controls (P < 0.01).The level of sVCAM-1 in blood was positively correlated with HB-EGF (P < 0.05). Blood sVCAM-1 was positively correlated with 24-hour urinary protein, urinary red blood cell count and coagulation function (P < 0.05). The levels of vWF, sVCAM-1 and HB-EGF increased most significantly in the spleen kidney yang deficiency syndrome group，and in blood stasis syndrome group were significantly higher than those in non blood stasis syndrome group (P < 0.01). Blood VWF, sVCAM-1 and HB EGF had good sensitivity and specificity in judging blood stasis syndrome of IgA nephropathy. Conclusion Patients with IgA nephropathy have severe inflammatory vascular endothelial injury. The degree of vascular endothelial damage is more serious in patients with spleen kidney yang deficiency syndrome and blood stasis syndrome. Blood VWF, sVCAM-1 and HB EGF have positive significance in judging the severity of the disease and guiding treatment. |
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