海南黎族与汉族狼疮性肾炎病理表现差异分析  

Analysis of pathological differences in lupus nephritis between the Li and Han ethnic groups in Hainan

作　　者：雷文娟 陈菊[1] 冯艳艳 周君[1] Lei Wenjuan;Chen Ju;Feng Yanyan;Zhou Jun(Department of Nephrology and Rheumatology,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine,Haikou 570100,China)

机构地区：[1]中南大学湘雅医学院附属海口医院肾病风湿科,海口570100

出　　处：《中国医师杂志》2024年第5期712-716,共5页Journal of Chinese Physician

基　　金：海南省卫生健康行业科研项目(21A200441)。

摘　　要：目的探讨海南地区黎族和汉族狼疮性肾炎(LN)患者的肾脏病理特征差异。方法回顾性分析2013年1月至2023年12月中南大学湘雅医学院附属海口医院肾病风湿科住院进行肾活检的135例系统性红斑狼疮(SLE)患者的肾脏病理资料,按民族不同分为黎族(n=22)和汉族患者(n=113),分析不同民族LN患者的SLE疾病活动性指数(SLEDAI-2000)评分、肾脏病理分型、肾小球硬化和肾小管间质病变。结果在随访期间黎族与汉族LN患者终末期肾病的发病率比较差异无统计学意义(13.6%vs 7.9%,P=0.656)。黎族LN患者SLEDAI-2000评分以轻度和中度活动为主,汉族LN患者以中度和重度活动为主,两组间SLEDAI-2000差异无统计学意义(P=0.577)。黎族和汉族LN患者病理分型均以Ⅳ/Ⅳ+Ⅴ为主,两组患者在Ⅰ、Ⅱ、Ⅲ/Ⅲ+V、Ⅳ/Ⅳ+Ⅴ、Ⅴ不同病理分型组间比较,差异无统计学意义(均P>0.05)。两组间AI、CI比较,差异无统计学意义(均P>0.05)。黎族和汉族LN患者肾小球硬化比例比较,差异无统计学意义(P>0.05)。但黎族LN患者急、慢性肾小管间质病变均重于汉族(P=0.008和P=0.038)。结论黎族LN患者终末期肾病发病率较汉族高,黎族LN患者肾脏病理的急性和慢性肾小管间质病变均重于汉族。Objective To explore the differences in renal pathological characteristics between Li and Han patients with lupus nephritis(LN)in Hainan region.Methods A retrospective analysis was conducted on the renal pathological data of 135 patients with systemic lupus erythematosus(SLE)who underwent renal biopsy in the Department of Nephrology and Rheumatology,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from January 2013 to December 2023.They were divided into Li(n=22)and Han(n=113)patients according to their ethnicity.The SLE disease activity index(SLEDAI-2000),renal pathological classification,glomerulosclerosis,and tubulointerstitial lesions of LN patients from different ethnicities were analyzed.Results During the follow-up period,there was no statistically significant difference in the incidence rate of end-stage renal disease in LN patients between Li nationality and Han nationality(13.6%vs 7.9%,P=0.656).The SLEDAI-2000 score of Li ethnic LN patients was mainly mild and moderate activity,while Han ethnic LN patients were mainly moderate and severe activity.There was no statistically significant difference in SLEDAI-2000 between the two groups(P=0.577).The pathological subtypes of LN patients in both Li and Han ethnic groups are mainlyⅣ/Ⅳ+Ⅴ.There was no statistically significant difference between the two groups in different pathological subtypes ofⅠ,Ⅱ,Ⅲ/Ⅲ+Ⅴ,Ⅳ/Ⅳ+Ⅴ,andⅤ(all P>0.05).There was no statistically significant difference in AI and CI between the two groups(all P>0.05).There was no statistically significant difference in the proportion of glomerulosclerosis between Li and Han LN patients(P>0.05).However,the acute and chronic renal tubulointerstitial lesions in Li ethnic LN patients are more severe than those in Han ethnic group(P=0.008 and P=0.038).Conclusions The incidence rate of end-stage renal disease in LN patients of Li nationality is higher than that in Han nationality.The acute and chronic renal tubular and interstitial lesions in LN patients

关 键 词：狼疮肾炎 肾小管间质病变 黎族 

分 类 号：R593.242[医药卫生—内科学]