男性狼疮性肾炎的临床和病理(附69例分析)  

CLINICAL AND PATHOLOGIC FEATURES OF LUPUS NEPHRITIS: A RETROSPEC TIVE ANALYSIS OF 69 MALE PATIENTS WITH LUPUS NEPHRITIS

作　　者：刘俊铎[1] 刘志红[1] 黎磊石[1] 

机构地区：[1]南京军区南京总医院解放军肾脏病研究所

出　　处：《肾脏病与透析肾移植杂志》1997年第4期319-328,共10页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的：观察男性狼疮性肾炎（ＬＮ）的流行病学、临床表现、肾脏病理、免疫学异常、治疗及预后，与女性患者对比，以期提高对男性ＬＮ的认识。方法：回顾分析６９例男性ＬＮ及同期４９５例女性患者的病理、临床及随访资料。结果：①男性患者占ＬＮ总数的１２．２６％，发病的高峰年龄为１５～３５岁；②男性ＬＮ合并心脏、肺、肝、浆膜腔、中枢神经、血液系统病变较女性多见（或严重），而发热、并节肿痛、皮疹、雷诺征较少见；③根据ＷＨＯ组织分型男性狼疮的肾脏病理类型基本上与女性一致，但事实上其血管病变、血栓形成、间质浸润较女性严重；④男性狼疮的临床表现与未成年女性患者较为相似；⑤男性ＬＮ对常规激素治疗反应不如女性明显，预后差，加用细胞毒药物、抗凝治疗后有改善。结论：男性狼疮在免疫学特征、病理形态、临床表现、治疗及预后上均与女性患者有别，应该强调“男性狼疮肾症候群”的特点。OBJECTIVE To study the difference between male and female patients with lupus nephritis, a retrospective clinical analysis was performed. METHODOLOGY The clinical and pathological features and the data of prognosis in 69 male lupus patients and 495 female lupus patients were analyzed in this study. RESULTS ① There are 12 26% male patients in all lupus patients in this study. More than 80% male patients are 15 to 35 years old at the onset of lupus. ② Irregular fever, skin rashes, arthritis and raynaud's phenomenon are less common in the males than in the females, but the male patients are more likely to suffer from cardiac, pulmonary, hepatic, nervous system and hematological abnormalities the female patients. ③ Although lupus nephritis in male is not much different from that in female patients, the vasculopathy, thrombosis and interstitial infiltration are more frequent and severe in male lupus patients. ④ The prognosis and the response to steroid in male patients are not as well as that in female patients. ⑤ The clinical, laboratory and pathologic features of male lupus nephritis are much like that of adolescent female patients. CONCLUSION We would like to introduce the “Male lupus nephritis syndrome” to emphasize the difference of male lupus nephritis from classic female lupus nephritis.

关 键 词：男性 狼疮性肾炎 病理 临床分析 

分 类 号：R593.242[医药卫生—内科学]