临床及肾脏病理与狼疮性肾炎肾脏损害的相关性  

The Correlation of the Lupus Nephritis Kidney Damage with Their Clinical and Renal Pathology

作　　者：韩晓静[1] 隋满姝[1] 郭小芳[1] 刘晓刚[1] 吴红赤[1] 解汝娟[1] 

机构地区：[1]哈尔滨医科大学附属第一医院肾内科,哈尔滨150001

出　　处：《中国中西医结合肾病杂志》2013年第2期134-137,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然科学基金资助项目(No.81150032);黑龙江省卫生厅基金资助项目(No.2007-179)

摘　　要：目的:探讨狼疮性肾炎(LN)患者临床及病理与肾脏损害之间的关系,明确肾脏损害的相关血清学指标及病理表现。方法:回顾性分析我院182例LN患者的临床及病理资料,进行统计学分析。结果:(1)LN患者Ⅳ型和Ⅴ型的肾脏损害(蛋白尿、血尿、血肌酐)最重,抗ds-DNA抗体、抗核小体抗体及补体C3降低在Ⅳ型多见。(2)血脂、血浆白蛋白及血红蛋白均与肾脏损害明显相关(P<0.01)。(3)肾脏损害指标升高时,免疫复合物C1q、C3、EM沉积均达90%以上;肾脏损害指标与AI、CI及其病理参数明显正相关。结论:血脂异常、低蛋白血症、贫血、抗ds-DNA抗体、核小体抗体及补体C3均为提示肾脏损害程度的血清学指标。Ⅳ型和Ⅴ型的肾脏损害最重,并且蛋白尿、血尿、血肌酐水平与肾脏的病理沉积相关。Objective： The purpose is to investigate the relationship between the lupus nephritis kidney damage and their clinical or renal pathology, and clear the kidney damage related serological indicators and pathological findings. Methods：The clinical and pathological data were measured and analyzed from 182 patients with lupus nephritis in a single centre. Results： （ 1 ） The indexes P （proteinuria, hematuria, and serum creatinine） of renal damage in patients with the class IV and V were the heaviest than that in pa- tients with class Ⅰ and Ⅱ , and it was commen in the class IV. that the prevalence for anti - dsDNA, anti - nucleosome and reduced complement Ca. （ 2 ） The levels of serum lipids, serum albumin and hemoglobin were significantly correlated with index of renal damage （P 〈0.01 ）. （3） When the index of renal damage elevated, their immune complexes of Ciq, Ca, EM deposited more than 90%. The indexes of renal damage were positively correlated with activity index, chronic index and its pathological indicators. Conclusion： Dyslipidemia, hypoproteinemia, anemia, anti - ds - DNA, anti - nucleosome and reduced complement C3 are prompted to kidney damage serological markers. The pathological type of the heaviest kidney damage is type IV and Type V moreover the levels of pro- teinuria, hematuria, and serum creatinine, are related with the renal pathological deposition.

关 键 词：狼疮性肾炎 病理类型 肾脏损害 活动指数 慢性指数 

分 类 号：R593.242[医药卫生—内科学]