Logistic regression analysis of influencing factors of syndrome differentiation in 417 patients with primary glomerulonephritis

JIA Meng; HAN Shisheng; WANG Yi

doi:10.3969/j.issn.2095-6606.2023.04.009

您当前的位置：

首页 >

文章列表页 >

Logistic regression analysis of influencing factors of syndrome differentiation in 417 patients with primary glomerulonephritis

Clinical Research | 更新时间：2023-08-07

- Logistic regression analysis of influencing factors of syndrome differentiation in 417 patients with primary glomerulonephritis
- Modern Chinese Clinical Medicine Vol. 30, Issue 4, Pages: 42-48(2023)
- 作者机构：
  
  上海中医药大学附属岳阳中西医结合医院肾内科　上海　200437
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.2095-6606.2023.04.009
  CLC： R259
- Published：30 July 2023，
  
  Received：26 September 2022，
- 稿件说明：
移动端阅览
JIA Meng, HAN Shisheng, WANG Yi. Logistic regression analysis of influencing factors of syndrome differentiation in 417 patients with primary glomerulonephritis. [J]. Modern Chinese Clinical Medicine 30(4):42-48(2023)
DOI：

JIA Meng, HAN Shisheng, WANG Yi. Logistic regression analysis of influencing factors of syndrome differentiation in 417 patients with primary glomerulonephritis. [J]. Modern Chinese Clinical Medicine 30(4):42-48(2023) DOI： 10.3969/j.issn.2095-6606.2023.04.009.

摘要

目的

基于Logistic回归分析探讨原发性肾小球肾炎患者标实证辨证影响因素。

方法

对417例上海中医药大学附属岳阳中西医结合医院肾内科、上海中医药大学附属龙华医院肾内科、上海中医药大学附属第七人民医院肾内科住院，并行活检病理检查的原发性肾小球疾病患者进行回顾性研究，采用无序多分类Logistic回归相关性分析，分析原发性肾小球疾病标实证与肾脏病理组织学病变和生化指标等35项自变量之间的相关性。

结果

无标实证患者184例，标实证(含标实合并证)233例，水湿证患者156例，湿热证患者65例，血瘀证患者9例。以无标实证为对照，水湿证的辨证影响因素为：24 h尿蛋白定量(

0.05)，呈正相关；血红蛋白(

0.05)，呈负相关；血清白蛋白(

0.05)，呈负相关。湿热证的辨证影响因素为血清白蛋白(

0.05)，呈负相关。血瘀证的辨证影响因素为肾小球细胞增殖程度积分(

0.05)，呈正相关。

结论

原发性肾小球肾炎患者水湿证辨证影响因素为24 h尿蛋白定量、血红蛋白、血清白蛋白，湿热证辨证影响因素为血清白蛋白，血瘀证辨证影响因素为肾小球细胞增殖程度积分。

Abstract

Objective

To investigate the influencing factors of standard empirical syndrome differentiation in patients with primary glomerulonephritis using logistic regression analysis.

Methods

A retrospective study was conducted on 417 patients with primary glomerular disease who were admitted to the Department of Nephrology at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine

the Department of Nephrology at Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine

and the Department of Nephrology at the Seventh People’s Hospital affiliated to Shanghai University of Traditional Chinese Medicine for concurrent biopsy and pathological examination. Random multiclass logistic regression correlation analysis was used to analyze the correlation between 35 independent variables such as primary glomerular disease markers and renal histopathological changes and biochemical indicators.

Results

There were 184 patients with non-standard empirical evidence

233 with standard empirical evidence (including combined standard empirical evidence)

156 with water dampness syndrome

65 with dampness heat syndrome

and 9 with blood stasis syndrome. Those with non-standard empirical evidence were used as a control

and the influencing factors of water dampness syndrome differentiation are: 24-hour urine protein quantification (

0.05)

showing a positive correlation

hemoglobin (

0.05)

negatively correlated

serum albumin (

0.05)

showing a negative correlation. The influencing factor of dampness heat syndrome differentiation is serum albumin (

0.05)

which is negatively correlated. The influencing factor of blood stasis syndrome differentiation is the integral of glomerular cell proliferation degree (

0.05)

which is positively correlated.

Conclusion

The influencing factors for the differentiation of water dampness syndrome in patients with primary glomerulonephritis are 24-hour urine protein quantification

hemoglobin

and serum albumin. The influencing factor for the differentiation of dampness heat syndrome is serum albumin

while the influencing factor for the differentiation of blood stasis syndrome is the degree of glomerular cell proliferation integral.

关键词

原发性肾小球疾病中医证候标实证肾脏病理生化指标

Keywords

primary glomerular diseaseTCM syndrome typesstandard empirical evidencerenal pathologybiochemical indicators

references

刘昌明，黄香尘，杜斌.肾脏病理诊断对肾功能不全的诊断作用研究[J].世界最新医学信息文摘，2019,19(44):169,172.

ZHU P，ZHOU F D，ZHAO M H.The renal histopathology spectrum of elderly patients with kidney diseases: a study of 430 patients in a single Chinese center[J/OL].Medicine(Baltimore),2014,93(28):e226[2022-03-20]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603081/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603081/.

易岚.邹燕勤治疗慢性肾小球肾炎的经验[J].江苏中医药，2015,47(12):11-13.

吕芳，王亿平，王东.曹恩泽辨治慢性肾炎经验[J].安徽中医学院学报，2010,29(3):30-32.

刘宏伟，王国栋，张国强.医坛巨匠时振声教授学术贡献撷萃[J].中医药学刊，2001,19(6):534-535.

叶任高.中西医结合肾脏病学[M].北京：人民卫生出版社，2003: 197.

邹万忠.肾活检病理诊断标准指导意见[J].中华肾脏病杂志，2001,17(4):270-275.

郑筱萸.中药新药临床研究指导原则(试行)[M].北京：中国医药科技出版社，2002: 157-162.

KATAFUCHI R，KIYOSHI Y，OH Y，et al.Glomerular score as a prognosticator in IgA nephropathy：its usefulness and limitation[J].Clin Nephrol，1998,49(1):1-8.

钱超尘.中藏经校注[M].北京：学苑出版社，2008: 33.

孙伟.湿热之邪在慢性肾炎进展中的作用[J].江苏中医药，2006,27(6):6-7.

王丽萍，陈建，庄永泽，等.IgA肾病湿热证与临床病理的相关性研究[J].中华中医药学刊，2008,26(1):178-180.

余江毅，熊宁宁，余承惠，等.血尿唾液酸、尿NAG与肾炎湿热证的关系[J].中国中西医结合杂志，1993,13(9):525-527.

盛梅笑，孙伟，贾宁人，等.肾炎湿热证血清sICAM－1变化的临床观察[J].辽宁中医杂志，2003,30(11):891-892.

朱辟疆，施荣华，刘永平.慢性肾小球疾病湿热证血浆及尿白介素－6的改变[J].浙江中西医结合杂志，1999,9(2):75-77.

程李涛.熊宁宁教授治疗慢性肾炎湿热证经验撷萃[J].中医药学刊，2003,21(3):348-349.

阮诗玮，郑敏麟，王智，等.IgA肾病湿热证与肾穿刺活检病理组织关系的临床研究[J].中国中西医结合肾病杂志，2003,4(10):583-584.

王碧飞，许韩师，李幼姬，等.Akt/NF-kB信号途径在免疫复合物诱导肾系膜细胞增殖中的作用[J].细胞与分子免疫学杂志，2004,20(3):314-318.

王惠民，朱妙珍，张建国.核因子－kB/IkB系统在慢性肾炎肾小球中的表达及意义[J].第三军医大学学报，2002,24(1):103-105.

张丽英，梦雅平.核转录因子－kB及结缔组织生长因子在IgA肾病中的表达及意义[J].实用医学杂志，2012,28(15):2543-2545.

王青，刘正兴，赵永明.TNF－α干预内皮细胞后MAPK与NF-kB之间关系的研究[J].大理学院学报，2010,9(6):22-25.

张国珍，吴小川，彭晓杰，等.黄芪对实验性IgA肾病大鼠肾小管间质损害及NF-kB、MCP－1表达的影响[J].中国当代儿科杂志，2008,10(2):173-178.

王新荣，万廷信，赵著华，等.IgA肾病中医湿热证微观辨证病理指标研究[J].中国中医药信息杂志，2015,22(8):31-35.

魏明刚，孙伟，程宗琦，等.加味当归补血汤抑制微炎症与慢性肾小球肾炎临床疗效的研究[J].中成药，2014,36(1):48-51.

班志勇，李毅琳，卢爱萍.中西医结合治疗瘀热型慢性肾炎疗效观察[J].广西中医药大学学报，2015,18(1):17-19.

庞欣，王琛.王琛从热毒瘀阻论治慢性肾炎蛋白尿经验[J].辽宁中医杂志，2012,39(1):33-35.

卢富华，朱初良.慢性肾炎瘀血病理的探讨[J].陕西中医，2000,21(4):164-165.

万廷信，戴恩来，王文革，等.IgA肾病中医邪实证候与靶器官病理特征的相关性研究[J].中国中西医结合杂志，2015,35(9):1044-1049.

程小红，于小勇，毛加荣.IgA肾病的病理改变与中医微观辨证[J].中国中西医结合肾病杂志，2014,15(2):185-186.

乔延恒，武士锋，杨洪涛.我国关于肾脏病理与中医证型关系研究近况[J].中国中西医结合肾病杂志，2013,14(11):1020-1021.

危成筠，陈香美，赵丹阳，等.IgA肾病血瘀证与临床病理的相关性研究[J].中国中西医结合杂志，2005,25(8):687-690.

王阶，李建生，姚魁武，等.血瘀证量化诊断及病证结合研究[J].中西医结合学报，2003,1(1):21-24.

刘春生，陈和平，韩淑莲，等.利肾血冲剂对慢性肾炎血瘀型患者血清中t-PA、PAI－1影响及临床意义[J].中医研究，2008,21(4):28-30.

向广生.慢性肾衰竭患者血瘀证与微炎症状态相关性的研究[D].北京：北京中医药大学，2013.

FABIANO R C，PINHEIRO S V，SIMOES E，et al. Immunoglobulin a nephropathy：a pathophysiology view[J].Inflamm Res，2016,65(10):757-770.

马宏.IgA肾病发病机制的研究进展[J].实用儿科临床杂志，2012,27(5):313-315.

曾小艳，李芳.IgA肾病的发病机制研究进展[J].大连医科大学学报，2011,33(5):503-506.

毛静仪.原发性慢性肾小球肾炎中医证型与肾脏病理的相关性研究[D].南京：南京中医药大学，2018.

田子鹤，远方.慢性肾小球肾炎中医证候及证素规律的文献研究[J].中医药导报，2019,25(23):37-39.

高国栋.基于大数据平台肾虚湿瘀理论下CKD中医证候学研究[D].南京：南京中医药大学，2020.

Views

123

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Association network analysis of heart rate variability-TCM syndrome type-inflammatory indicator in essential hypertension

Related Author

ZHANG Gaoyu

WANG Zihan

HE Qing

LI Lingling

FAN Jiarong

HUANG Li

XIAO Xiang

SHI Haoyue

Related Institution

Beijing University of Chinese Medicine

The First Hospital of Hebei Medical University

Japan Friendship Hospital

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University

⁰