Nco ntsoov Cov Neeg Mob Nrog IgA nephropathy! Dyslipidemia cuam tshuam rau kev kwv yees
May 09, 2023
Immunoglobulin A (IgA) nephropathy yog ib hom kab mob glomerular thoob ntiaj teb, suav txog li 50 feem pua ntawm thawj cov kab mob glomerular hauv kuv lub tebchaws. Cov kev tshawb fawb yav dhau los tau qhia tias dyslipidemia feem ntau tshwm sim hauv ntau cov kab mob hauv lub raum (CKD) thiab tseem yog ib qho kev pheej hmoo ntawm CKD. Nyob rau tib lub sijhawm, cov ntaub ntawv qhia tias dyslipidemia feem ntau tshwm sim hauv cov neeg mob IgA nephropathy. Yog li, dab tsi yog qhov cuam tshuam ntawm dyslipidemia rau cov neeg mob nrog IgA nephropathy?
Nyem rau cistanche herba rau mob raum
Thaum Lub Plaub Hlis 14, 2023, Lub Raum Ntshav Siab tau tshaj tawm txoj kev tshawb fawb los ntawm Lub Tsev Haujlwm Saib Xyuas Kev Kho Mob Nephrology, Longhua Tsev Kho Mob Koom Tes nrog Shanghai University of Traditional Chinese Medicine, Suav. zoo sib xws rau prognosis.
Cov ntsiab lus tseem ceeb
① Qhov kev faib ua feem ntawm M1 thiab T1 ~ 2 hom hauv pawg dyslipidemia tau nce siab dua li ntawm pawg tsis yog dyslipidemia (P<0.001).
② Kaplan-Meier survival nkhaus tsom xam pom tias piv nrog cov pab pawg uas tsis yog-dyslipidemia, qhov kev cia siab ntawm cov neeg mob dyslipidemia yog qhov phem dua (P=0.048).
Txoj kev
Txoj kev tshawb no yog ib qho kev tshawb nrhiav rov qab los soj ntsuam kev sib raug zoo ntawm IgA nephropathy thiab dyslipidemia. Cov txheej txheem suav nrog yog cov neeg mob IgA nephropathy tau lees paub los ntawm lub raum biopsy, thiab cov txheej txheem cais tawm yog ① theem nrab IgA nephropathy; ② ua ke nrog cov kab mob lupus erythematosus (SLE), Henoch-Schonlein purpura lossis qog nqaij hlav loj; ③ glomerulus suav nrog cov txiaj ntsig ntawm lub raum biopsy Quantity<10.
Cov neeg mob tau ua raws li 1 xyoos, thiab tsawg kawg ib zaug txhua 3 lub hlis rau kev soj ntsuam thiab tshuaj xyuas. Qhov kawg ntawm txoj kev tshawb no yog qhov kwv yees glomerular filtration rate (eGFR) tsawg dua los yog sib npaug li 50 feem pua ntawm cov hauv paus los yog kev loj hlob mus rau theem kawg ntawm lub raum kab mob (ESKD). Hauv tsab xov xwm no, cov ntsiab lus ntawm dyslipidemia thiab nws cov pab pawg ua raws li "Cov Lus Qhia rau Kev Tswj Xyuas Dyslipidemia hauv Suav Cov Neeg Laus" luam tawm xyoo 2016.
Kev tshwm sim
Tag nrho ntawm 234 tus neeg mob uas muaj IgA nephropathy tau sau npe, suav nrog 101 txiv neej thiab 103 tus poj niam, nrog rau hnub nyoog nruab nrab ntawm 39.0, 119 tus neeg mob hauv pawg dyslipidemia, thiab 115 tus neeg mob hauv pawg tsis yog dyslipidemia. Feem ntau ntawm dyslipidemia yog 50.9 feem pua. Cov pab pawg dyslipidemia tuaj yeem muab faib ua 4 pawg raws li cov tsos mob, xws li pab pawg neeg siab triglyceride (43 tus neeg), pawg hypercholesterolemia (13 tus neeg), pawg sib xyaw hyperlipidemia (19 tus neeg), thiab pawg HDL cholesterol tsawg (44. cas). Tus naj npawb ntawm cov neeg mob hauv CKD 1 thiab CKD 2-5 yog 115 thiab 119, feem.
Tsis muaj qhov sib txawv tseem ceeb ntawm lub hnub nyoog, lub sijhawm los ntawm kev mus ntsib thawj zaug rau biopsy, ntshav urea nitrogen, thiab cov ntshav albumin ntawm pawg dyslipidemic thiab normolipidemic. Txawm li cas los xij, piv nrog cov pab pawg uas tsis yog dyslipidemia, systolic ntshav siab, ntshav siab diastolic, ntshav creatinine, uric acid, hemoglobin, proteinuria, thiab eGFR yog tag nrho cov siab dua hauv pawg dyslipidemia (P.<0.05). More importantly, the typing of IgA patients in the dyslipidemia group was significantly different from that in the non-dyslipidemia group (P<0.001). Specifically, the proportions of M1 and T1~2 types in the dyslipidemia group were significantly higher than those in the non-dyslipidemia group.
Qhov tseem ceeb, hauv kev txheeb xyuas pawg ntawm pawg dyslipidemia, muaj qhov sib txawv ntawm pawg sib txawv hauv uric acid, serum albumin, thiab proteinuria (P.<0.05). In other aspects, such as renal biopsy results, eGFR, blood pressure, creatinine, blood urea nitrogen, etc., there was no significant difference.
Multivariate regression tsom xam pom tias txiv neej pw ua ke (los yog=2.397; 95 feem pua CI, 1.051~5.469; P=0.038) thiab proteinuria (OR=1.000; 95 feem pua CI, 1.000~1.001; P=0.035) muaj kev cuam tshuam loj rau cov ntshav lipid hauv cov neeg mob uas muaj IgA nephropathy. Anomalies muaj qhov cuam tshuam loj heev.
Tag nrho ntawm 17 tus neeg mob (9.4 feem pua) muaj cov xwm txheej kawg, ntawm 8 tus neeg mob tau txo qis hauv eGFR Ntau dua lossis sib npaug li 50 feem pua ntawm cov hauv paus, thiab 9 tus neeg mob tsim ESKD. Kaplan-Meier survival nkhaus tsom xam pom tias piv nrog cov pab pawg uas tsis yog-dyslipidemic, cov neeg mob hauv pawg dyslipidemia muaj qhov tshwm sim tsis zoo (P=0.048, Daim duab 1).
Daim duab 1 Kaplan-Meier survival nkhaus tsom xam daim duab
Lus Cim: Xiav yog pab pawg dyslipidemia, liab yog pawg tsis yog dyslipidemia
Sib tham
Txoj kev tshawb no tau lees paub tias nyob rau hauv cov neeg mob uas muaj IgA nephropathy, dyslipidemia tsis yog tsuas yog cuam tshuam nrog kev tshwm sim ntawm cov hlab plawv, tab sis kuj tseem cuam tshuam txog kev poob ntawm lub raum ua haujlwm hauv IgA nephropathy. Kev tshawb fawb tam sim no qhia tau hais tias kwv yees li 45.3 feem pua -61.1 feem pua ntawm cov neeg laus nrog IgA nephropathy raug kev txom nyem los ntawm dyslipidemia. Nyob rau tib lub sijhawm, dyslipidemia tseem cuam tshuam cov txiaj ntsig ntawm lub raum biopsy hauv cov neeg mob IgA nephropathy.
Cov xwm txheej saum toj no qhia tias dyslipidemia tuaj yeem hloov lub raum qauv ntawm cov neeg mob nrog IgA nephropathy thiab ua rau lub raum ua haujlwm puas tsuaj. Tus qauv nas ntawm IgA nephropathy qhia tau hais tias lipids feem ntau faib rau hauv thaj chaw cortical thiab tubular ntawm lub raum. Lipid tsub zuj zuj tuaj yeem ua rau muaj kev phom sij rau lub raum hlwb hauv cov cheeb tsam no, ua rau muaj kev phom sij xws li mob thiab oxidative kev nyuaj siab.
Hauv kev xaus, txoj kev tshawb no qhia tias dyslipidemia muaj feem cuam tshuam nrog IgA nephropathy kev faib tawm, kab mob kev loj hlob, thiab kev kwv yees. Cov kev taw qhia kev tshawb fawb tom ntej no yuav tsum tau txiav txim siab txog kev sib raug zoo ntawm ob qho los ntawm kev tshawb fawb loj, thiab seb kev txhim kho dyslipidemia puas tuaj yeem pab txhim kho IgA nephropathy Tus neeg mob lub raum kab mob mus ntxiv.
Lub mechanism ntawm Cistanche extract kho mob raum
Cistanche extract yog ib hom tshuaj suav tshuaj siv los kho ntau yam kab mob, suav nrog kab mob raum. Cov txheej txheem ntawm kev ua ntawm Cistanche extract hauv kev kho mob raum muaj ntau yam.
1. Anti-inflammatory zog: Cistanche extract muaj natural compounds uas muaj anti-inflammatory zog. Cov tshuaj no pab txo qhov mob ntawm lub raum, uas tuaj yeem txo qhov kev puas tsuaj los ntawm kab mob raum.
2. Antioxidant zog: Cistanche extract kuj muaj cov antioxidants uas pab tiv thaiv lub raum ntawm oxidative kev nyuaj siab. Oxidative stress tshwm sim thaum muaj qhov tsis sib xws ntawm cov dawb radicals thiab antioxidants hauv lub cev. Qhov no tuaj yeem ua rau lub raum puas thiab ua rau muaj kab mob raum.
3. Kev txhim kho lub raum: Cistanche extract tau pom los txhim kho lub raum ua haujlwm hauv kev tshawb fawb tsiaj. Nws tuaj yeem pab txo qis proteinuria, uas yog cov tsos mob ntawm cov kab mob hauv lub raum, thiab tseem txo qis cov ntshav creatinine thiab ntshav urea nitrogen (BUN), uas yog cov cim ntawm lub raum ua haujlwm.
4. Kev hloov kho lub cev tiv thaiv kab mob: Cistanche extract tuaj yeem pab kho lub cev tiv thaiv kab mob, uas tuaj yeem txo qhov kev mob raum. Tshwj xeeb, nws tuaj yeem pab tswj kev ua haujlwm T cell, uas tuaj yeem txo qhov mob hauv lub raum thiab txhim kho lub raum ua haujlwm.
Zuag qhia tag nrho, kev siv Cistanche extract hauv kev kho mob raum yog kev cog lus.
Cov ntaub ntawv:
1. Liu S, Lu Z, Fu Z, et al. Clinicopathological yam ntxwv thiab cov txiaj ntsig ntawm Immunoglobulin A nephropathy nrog ntau hom Dyslipidemia: Kev Tshawb Fawb Kev Tshawb Fawb Ib Leeg. Ntshav Qab Zib Res. 2023 Plaub Hlis 14; 48(1):186 -193.
