狼疮肾炎184例病理分型与临床表现分析  

Pathological types of lupus nephritis:a clinicopathological analysis of 184 cases

作　　者：陈素娟[1] 赵明辉[2] 

机构地区：[1]福建中医药大学病理学教研室,福州350108 [2]北京大学第一医院肾内科,北京100034

出　　处：《临床与实验病理学杂志》2012年第12期1329-1331,1335,共4页Chinese Journal of Clinical and Experimental Pathology

基　　金：国家自然科学基金(81021004);福建省医学会临床科研基金(2011ZYC-A58)

摘　　要：目的分析狼疮性肾炎(lupus nephritis,LN)的各病理类型及其与临床表现的关系,探讨LN的病变规律。方法回顾性分析2010年1月～2012年1月在北京大学第一医院治疗的184例LN患者的临床资料,比较不同病理分型的LN患者临床表现的差异。结果 (1)弥漫性增殖性肾炎(Ⅳ型)最多见,共66例(35.9%),以肾病综合征和肾功能不全多见;(2)临床表现以水肿、发热、关节炎相对多见,其中水肿、高血压以Ⅳ型最为多见,组间比较差异具有统计学意义(P<0.05);(3)Ⅳ型、Ⅴ+Ⅳ型肾炎患者的24 h蛋白尿、血肌酐、尿素氮升高、血红蛋白降低等较其他组更为严重;(4)Ⅳ型、Ⅴ+Ⅳ型肾炎AI、CI评分均明显高于其他各组(P<0.05),各组间SLED AI评分差异不明显(P>0.05)。结论同分型的LN具有不同的临床表现和实验室检查,对分型诊断、临床治疗具有指导意义。Purpose To explore the clinical manifestation and pathologic characteristics of different types of lupus nephritis. Methods The pathological category and clinical characteristics of lupus nephritis were analyzed, admitted in Peking University Third Hospital from January, 2010 to January, 2012, retrospectively. Results The type 1V was the most commonly found in the patients, and its clinical characteristic was nephrotic syndrome and renal dysfunction. The most popular clinical manifestations were edema, fever and arthritis, especially in type 1V lupus nephritis, which had obviously different from other types （P 〈 0. 05）. 24 h Upr, BUN and SCR in types IV and V ＋ IV were significantly higher than other histological types ; HGB in types IV and V ＋ IV was significantly lower than that of other types （P 〈 0. 05）. AI and CI scores in types IV, V ＋ IV were significantly higher than that in other types （P 〈 0. 05 ）. SLED AI scores among the different groups had no significant differences （P 〉 0. 05 ）. Conclusions The different types of lupus ne- phritis have different clinical manifestation and laboratory examination, which play a guiding role in clinical diagnosis, classification and treatment of lupus nephritis.

关 键 词：狼疮肾炎 病理分型 临床表现 

分 类 号：R593.24[医药卫生—内科学] R692.3[医药卫生—临床医学]