红斑狼疮合并抗磷脂抗体和抗磷脂抗体相关性肾病急性肾组织病理损伤的临床特点  

Clinical characteristics of lupus patients with positive antiphospholipid antibody and acute histopathologic lesion of antiphospholipid antibody associated nephropathy

作　　者：高瑞通[1] 程歆琦[2] 刘静[2] 俞文清[1] 文煜冰[1] 李雪梅[1] 郑法雷[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院肾内科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院检验科,北京100730

出　　处：《基础医学与临床》2012年第12期1395-1399,共5页Basic and Clinical Medicine

基　　金：国家(重点)实验室专项经费(2060204);北京协和医院2010年度院内青年基金(2010129)

摘　　要：目的分析系统性红斑狼疮(SLE)合并抗磷脂抗体(APL)和抗磷脂抗体相关性肾病(APLN)的急性肾组织病理损伤患者的临床特点,以促进对APLN的研究。方法回顾性分析北京协和医院2000至2005年期间100例SLE患者的临床特点及预后。分研究组:7例SLE合并APL和APLN急性损伤患者;2个对照组:APL阴性合并APLN急性损伤样病变7例(对照组1),APL阴性且无APLN肾组织病理损伤86例(对照组2)。结果研究组患者的血压为156±13/92±9 mmHg,肾活检时血肌酐为159±88μmol/L。高血压的发生率为85.7%,血肌酐升高的比例为42.8%。随诊2年时血肌酐为114±60μmol/L。与对照组2相比,研究组的血压(包括收缩压、舒张压及平均动脉压)、血肌酐水平以及肾功能不全的比例明显增高,随诊2年后的血肌酐也更高(P<0.05)。但研究组与对照组1相比无显著差异。结论 SLE合并APL及APLN急性损伤患者的血压和血肌酐水平较高,肾脏预后较差。Objective To investigate the clinical characteristics of lupus patients with positive antiphospholipid antibody（APL） and acute histopathologic lesion of antiphospholipid antibody associated nephropathy（APLN）.Methods Data of 100 cases of Systemic Lupus Erythematosus（SLE） admitted to Peking Union Medical College Hospital from 2000 to 2005 was investigated by retrospective analysis.Seven cases of lupus patients with positive antiphospholipid antibody（APL） and acute lesion of APLN were included in the study group.The control groups were divided into control group 1（7 cases of lupus patients with negative APL and acute lesion of APLN-like renal lesions） and control group 2（86 cases of lupus patients without APL or APLN）.Results The blood pressure and the serum creatinine at biopsy and two years later in patients in the study group were 156±13/92±9 mmHg,159±88 μmol/L and 114±60 μmol/L,respectively.The prevalence of high blood pressure and high serum creatinine were 85.7% and 42.8%,respectively.The blood pressure including systolic and diastolic blood pressure and mean arterial pressure,the serum creatinine level at biopsy and two years later,the prevalence of renal insufficiency were significantly higher in the study group compared with the control group 2（P0.05）.However there was no significantly difference between the study group and the control group 1.Conclusions Lupus patients with APL and acute histopathologic lesion of APLN showed higher blood pressure,higher serum creatinine level and poor renal prognosis.

关 键 词：系统性红斑狼疮 抗磷脂抗体 抗磷脂抗体相关性肾病 

分 类 号：R593.2[医药卫生—内科学]