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

作　　者：胡爱霞[1] 刘涛[1] HU Ai-xia;LIU Tao(Department of Nephrology,the Second Hospital of Huangshi City,Huangshi 435002,China)

机构地区：[1]湖北省黄石市第二医院肾病内科

出　　处：《临床肾脏病杂志》2019年第10期765-768,777,共5页Journal Of Clinical Nephrology

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。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.

关 键 词：狼疮肾炎 血管病变 临床病理 

分 类 号：R73[医药卫生—肿瘤]