胡爱霞, 刘涛. 肾间质血管病变对狼疮肾炎患者临床病理及预后的影响[J]. 临床肾脏病杂志, 2019, 19(10): 765-768,777. DOI: 10.3969/j.issn.1671-2390.2019.10.010
    引用本文: 胡爱霞, 刘涛. 肾间质血管病变对狼疮肾炎患者临床病理及预后的影响[J]. 临床肾脏病杂志, 2019, 19(10): 765-768,777. DOI: 10.3969/j.issn.1671-2390.2019.10.010
    HU Ai-xia, LIU Tao. Effect of renal interstitial vascular lesions on clinical pathological features and outcomes of lupus nephritis[J]. Journal of Clinical Nephrology, 2019, 19(10): 765-768,777. DOI: 10.3969/j.issn.1671-2390.2019.10.010
    Citation: HU Ai-xia, LIU Tao. Effect of renal interstitial vascular lesions on clinical pathological features and outcomes of lupus nephritis[J]. Journal of Clinical Nephrology, 2019, 19(10): 765-768,777. DOI: 10.3969/j.issn.1671-2390.2019.10.010

    肾间质血管病变对狼疮肾炎患者临床病理及预后的影响

    Effect of renal interstitial vascular lesions on clinical pathological features and outcomes of lupus nephritis

    • 摘要: 目的 探讨肾间质血管病变在狼疮肾炎(lupus nephritis,LN)中的意义。方法 回顾性分析2010年1月至2015年12月经临床及肾活检证实为LN的患者51例,根据光镜下有无血管病变将患者分为血管病变组和无血管病变组。比较两组临床、实验室检查及病理特点。结果 51例患者中男性9例(17.6%),女性42例(82.4%),平均年龄(33.9±11.0)岁,平均发病年龄(31.3±11.3)岁,系统性红斑狼疮病程23(0.5~156)个月,LN病程3(0.1~144)个月。与无血管病变组相比,血管病变组慢性肾衰竭比例明显高于无血管病变组(P=0.001),贫血更明显(P=0.003),血清肌酐更高(P=0.003),估算肾小球滤过率明显低于无血管病变组(P=0.001);抗双链DNA抗体阳性率较高(P=0.047);肾活检见白金耳比例明显高于无血管病变组(P=0.001);肾间质浸润细胞评分(P=0.037)及慢性病变评分(P=0.037)、肾组织慢性指数(P=0.014)均高于无血管病变组。结论 有肾间质血管病变的LN患者肾脏损害较重,肾活检见狼疮活动性较高,同时慢性病变亦较重,远期肾脏预后较差。

       

      Abstract: Objective To analyze the significance of renal interstitial vascular lesions in clinical treatment of lupus nephritis(LN). Methods Fifty-one patients diagnosed with LN through clinical manifestations and renal biopsy from January of 2010 to December of 2015 were divided into two groups into vascular lesion group and non-lesion group according to whether there is vascular lesions under a microscope. Retrospective analysis was performed; the clinical, laboratory, pathological manifestations and outcomes were compared between the two groups. Results Among the 51 patients, 9 ones were male (17.6%) and 42 ones were female (82.4%), with a mean age of (33.9±11.0), and a mean onset age of (31.3 ±11.3). Systemic lupus erythematosus course was 23 (0.5-156) months, LN course was 3 (0.1-144) months. In the vascular lesion group, chronic renal failure rate in the vascular lesion group was significantly higher than that in the non-lesion group (P=0.001); anemia was more obvious (P=0.003), serum creatinine was higher (P=0.003), and the estimated glomerular filtration rate was significantly lower (P=0.001); the positive rate of ds-DNA was higher (P=0.047).; the proportion of platinum loop in renal biopsy was significantly higher than that in non-lesion group (P=0.001); renal interstitial infiltration cell score (P=0.037), chronic lesion score (P=0.037) and chronic renal tissue index (CI) (P=0.014) were all higher than those in the non-lesion group. Conclusions The LN patients with renal interstitial vascular lesions have more obvious damage, and renal biopsy shows lupus activity is more obvious, chronic lesions are more serious, and long-term renal prognosis is poor.

       

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