目的 探討不同性別IgA腎病患者合并高尿酸血癥的臨床及腎臟病理特點。 方法 采用回顧性研究方法，將2008年1月－2010年12月收治的226例經腎活檢確診的原發性IgA腎病患者分為男性高尿酸血癥組、男性尿酸正常組、女性高尿酸血癥組及女性尿酸正常組4組，統計分析4組的臨床指標及病理指標。 結果 高尿酸血癥患病率男性（21.7%）高于女性（11.9%），差異有統計學意義（P＜0.01），尿檢異常型患病率男性（14.6%）高于女性（4.0%），差異有統計學意義（P＜0.01），女性LeeⅢ級的患病率（7.1%）高于男性（5.8%），差異有統計學意義（P＜0.01）；男性高尿酸血癥組的尿素氮高于尿酸正常組（P＜0.05），女性高尿酸血癥組的血尿素氮、血肌酐、胱抑素C、舒張壓、甘油三酯比尿酸正常者明顯增高（P＜0.01），女性高尿酸血癥組的高密度脂蛋白明顯高于男性組（P ＜0.01）。 結論 高尿酸血癥是IgA腎病的危險因素，可導致更嚴重的腎功能損害及腎臟病理損害，這種影響在不同性別中存在差異。
Objective To systematically review the efficacy of total glycosides extracted from Rehmannia glutinosa Libosch leaf in the treatment of diabetic nephropathy. Methods Databases including PubMed, EMbase, MEDLINE, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP were electronically searched to collect randomized controlled trials of total glycosides from Rehmannia glutinosa Libosch for diabetic nephropathy from inception to May 30th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. RevMan 5.4 software was then used to perform meta-analysis. Results A total of 7 RCTs involving 504 patients were included. The results of meta-analysis showed that there were no significant differences in creatinine levels (MD=?1.71, 95%CI ?3.97 to 0.56, P=0.14) and urea (MD=?0.18, 95%CI ?0.44 to 0.08, P=0.19) between the two groups. In terms of regulating proteinuria, the urinary albumin excretion rate (MD=?39.41, 95%CI ?48.46 to ?30.36, P<0.000 01), urinary microalbumin (MD＝?9.94, 95%CI ?12.16 to ?7.73, P<0.000 01), and 24-hour urinary protein (MD=?0.67, 95%CI ?0.85 to ?0.49, P<0.000 01) were all lower in the treatment group compared with control group. However, there were no differences between groups in terms of blood glucose metabolism as indicated by changes in levels of the long-term blood glucose metabolism indicator (HbA1c: MD=?0.16, 95%CI ?0.67 to 0.35, P=0.53). Only one study suggested that short-term blood glucose metabolism indicators, fasting blood glucose and postprandial blood glucose levels were not different between groups. In terms of blood lipid metabolism, only one study suggested glycoside treatment produced lower serum levels of cholesterol and triglycerides compared with control group. Conclusions Current evidence suggests that adjunctive therapy with total Rehmannia glutinosa Libosch glycosides can benefit diabetic nephropathy patients more than angiotensin II receptor inhibitor or pancreatic kininogen by alleviating proteinuria and likely improving lipid metabolism. However, no benefit is observed in terms of renal function improvement or blood glucose metabolism. Due to limited quality and quantity of included studies, more high-quality studies are required to verify the above conclusions.
目的 探討抗核抗體（ANA）在IgA腎病中的陽性率及其對臨床的意義。 方法 回顧性分析2007年1月－2009年12月間進行ANA檢測的115例IgA腎病患者及59例非IgA腎病慢性腎炎患者的臨床資料。統計分析ANA陽性與陰性的臨床指標。 結果 IgA腎病患者中有12例（10.4%）存在ANA陽性，與非IgA腎病慢性腎炎中的陽性率比較差異無統計學意義（P＞0.05），ANA陽性的IgA腎病血漿IgG水平較高，病理改變較輕。 結論 IgA腎病ANA陽性的機體免疫有增強，腎功、尿蛋白及病理損害較輕，其對IgA腎病預后的影響仍需進一步研究。
Objective To assess the efficacy and safety of okra capsule for IgA nephropathy. Methods All randomized or quasi-randomized controlled trials (RCTs or quasi-RCTs) of okra capsule for IgA nephropathy were collected from CENTRAL, MEDLINE, EMbase, PubMed, WanFang Data, CNKI and CBM. Two reviewers independently screened the included studies, extracted the data, assessed the quality, and cross-checked then. Then RevMan 5.07 software was used for meta-analysis. Results Five RCTs were included. The results of meta-analyses showed that: compared with the control group, okra capsule was more effective in decreasing urinary protein (P≥0.05), but had no significant difference in improving renal function, reducing urine red blood cells and blood lipid (Plt;0.05). No research reported the adverse effects of okra capsule. Conclusion Current evidence reveals that okra capsule can reduce urinary protein and improving therapeutic effect for IgA nephropathy. However, further studies are needed to test its safety. Because of the small sample size and low methodological quality of the included studies, these results require more high-quality RCTs for further verification.