狼疮性肾炎合并肺胸膜病变的临床分析  

Clinical Analysis on Pulmonary and Pleural Involvement in Patients with Lupus Nephritis

作　　者：周燕斌[1] 叶任高[1] 谢灿茂[2] 李幼姬[1] 

机构地区：[1]中山大学附属第一医院肾内科.卫生部肾脏病临床研究重点实验室,广州510080 [2]中山大学附属第一医院呼吸内科,广州510080

出　　处：《中国中西医结合肾病杂志》2003年第1期20-23,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：中山医科大学 2 11工程重点科研基金资助项目 (No .9815 1)

摘　　要：目的 :探讨狼疮性肾炎 (LN)患者合并肺胸膜病变的特点及转归。方法 :回顾分析了资料完整的 170例LN合并肺胸膜病变的临床资料。结果 :6 4 5例LN中有 170例患者出现肺胸膜病变 ,占 2 6 .4 % ,其中伴有胸膜病变37.6 % ,胸腔积液 2 4 .1% ,间质性肺炎 2 7% ,急性狼疮肺炎 9.4 %。肺功能损害以弥散功能减低和小气道功能障碍为主。弥漫增生型LN发生肺部炎症性改变 ,胸膜腔渗出 ,并发心脏、神经损害的比率较其他类型显著增高。有肺胸膜损害的LN患者恶化死亡率显著高于无肺胸膜损害者 ,其病情较重 ,预后差 ,继发肺部感染更差。结论 :对已确诊为LN患者应定期作血常规及胸部X线检查 ,以便早期发现肺胸膜病变 ,调整治疗 。Objective:To study the clinical characteristics and prognosis of pulmonary and pleural involvement in patients with lupus nephritis(LN).Methods:Clinical data of pulmonary and pleural involvement in 170 LN patients were analyzed retrospectively.Results:Thoracopathy was found in 170 cases of 645 LN patients(26.4%),including pleura lesion (37.6%) ,pleural effusion (24.1%),interstitial pneumonia 27%,and acute lupus pneumonia (9.4%).Decreased diffusion capacity and dysfunction of small airway were the common findings of pulmonary functional lesions. The prevalences of lung inflammation, pleural effusion,heart lesion and nerve damage in the patients with diffuse proliferative LN were significantly higher than those in other types of LN. The deterioration and death rate was significantly higher in patients with pulmonary and pleural involvement than in that without involvemeut. More severe condition and worse prognosis were foung in patients with pulmonary and pleural involvement particularly in those with secondary pulmonary infections.Conclusion:In order to detect thoracopathy earlier and to adjust the treatment and improve prognosis, regular blood routine and chest X-ray examinations are recommended in patients with established LN.

关 键 词：临床分析 狼疮性肾炎 肺胸膜病变 发生率 肺功能 预后 并发症 

分 类 号：R692.3[医药卫生—泌尿科学]