60例狼疮性肾炎的临床与病理Clinical Data and Pathology of 60 Cases of Lupus Nephritis
梁继红,朱春玲,陈佳
LIANG Jihong1,ZHU Chunling1,CHEN Jia2 (1.Department of Nephrology
摘要(Abstract):
目的:探讨狼疮性肾炎(LN)患者的临床表现、实验室检查与病理类型之间的关系。方法:住院LN患者60例在B超下行肾活检及常规实验检查并进行病理分型。结果:60例LN病人中病理类型以Ⅳ型最多,占58.3%,其次是Ⅴ型(35.0%),Ⅳ型多表现为肾病综合征,Ⅴ型多表现为肾炎综合征及肾病综合征,激素和免疫抑制剂是治疗LN的主要药物。结论:系统性红斑狼疮的临床表现复杂,肾脏是主要受累器官。LN的病理类型与临床表现有一定关系,肾活检对判断疾病活动性、指导治疗与估计预后有重要意义。
Objective:To explore the clinical manifestation of patients with lupus nephritis(LN),and the relationship between laboratory examination results and pathologic classification.Methods:Renal biopsy and routine laboratory tests were performed to 60 hospitalized LN patients.The pathologic classification of LN was made according to the World Health Organization standards(1995).Results:In 60 cases,the most common type was type Ⅳ(58.3%),and Type Ⅴ ranked the second(35.0%).Patients with type Ⅳ mainly demonstrated as nephritic syndrome(NS),and patients with type Ⅴ mainly demonstrated as glomerulonenephritis and nephritic syndrome.The main drugs for treatment of LN were hormone and immune inhibitor.Conclusions:Clinical manifestation of systemic LN is complex,and kidney is the mainly involved organ.Pathologic classification correlates with clinical manifestation to some degree.Renal biopsy is significant in judging disease activity,guiding treatment,and estimating prognosis.
关键词(KeyWords):
狼疮肾炎;活组织检查;病理学
lupous nephritis;biopsy;pathology
基金项目(Foundation):
作者(Author):
梁继红,朱春玲,陈佳
LIANG Jihong1,ZHU Chunling1,CHEN Jia2 (1.Department of Nephrology
DOI: 10.19367/j.cnki.1000-2707.2011.04.012
参考文献(References):
- [1]王海燕.肾脏病学[M].3版.北京:人民卫生出版社,2008:1321-1342.
- [2]Mcclusery RT.The value of the renal biopsy in lupus ne-phritis arrithtis[J].Rheum,1982(25):867.
- [3]Weening JJ,D'Agati VD,Schwartz MM,et al.The classifi-cation of glomerulonephritis in systemic Lupus erythmatousrevisited[J].Kidney Int,2004(65):521-530.
- [4]叶任高,沈清瑞.肾脏病诊断与治疗学[M].北京:人民卫生出版社,1995:271-280.
- [5]Bombardier C,Gladman DD,Urowitz MB,et al.Derivationof the SLEDAI:a disease activity index for Lupus patients[J].Arthritis Rheum,1992(21):1468-1471.
- [6]黎磊石,关天俊,刘志红,等.4 298例成人肾小球疾病病理类型及流行病学特点[J].肾脏病与透析肾移植杂志,1997(2):109-111.
- [7]邹万忠,王海燕.狼疮肾炎病理学分类的演变和现状[J].中华肾脏病杂志,2004(5):377-379.
- [8]孙海鸥,胡伟新,谢红浪,等.V型狼疮性肾炎的远期预后[J].肾脏病与透析肾移植杂志,2007(1):14-18.
- [9]胡伟新,刘春蓓,孙海鸥,等.1 352例狼疮性肾炎的临床与免疫学特征[J].肾脏病与透析肾移植杂志,2006(15):401-408.
- [10]尹爱萍,郝大鹏,范春元,等.狼疮性肾炎108例临床与病理研究[J].陕西医学杂志,2002(2):121-124.
- [11]李艳秋,马健飞,冯江敏,等.52例狼疮性肾炎临床与病理相关关系的研究[J].中国医科大学学报,2005(5):457-461.
- [12]黎磊石,刘志红.肾小球疾病免疫抑制剂治疗的新方向——多靶点免疫抑制治疗[J].肾脏病与透析肾移植杂志,2007(1):3-4.
- [13]Cameron JS.Lupus Nephritis[J].J Am Soc Nephrol,1999(2):413-424.
- [14]姜党,胡媛芳.肾脏病理学参数在狼疮性肾炎中的应用[J].中华肾脏病杂志,1994(1):19-21.
- [15]陶凤武,廖履坦,吴兆龙,等.弥漫增殖性狼疮性肾炎[J].中华肾脏病杂志,1994(4):221-223.
- [16]Ravinal RC,Costa RS,Coimtia TM,et al.Classes,activityand chronicity indices,and alpha-smooth muscle actin ex-pression as prognostic parameters in lupus nephritis out-come[J].Lupus,2002(2):82-87.
- [17]余学清,陈楠.狼疮性肾炎治疗现状及应注意的几个问题[J].中华肾脏病杂志,2002(1):7-8.
- [18]林善锬.继发性肾小球疾病诊治中的几个重要问题[J].中国实用内科杂志,2002(9):55-516.
- [19]张乃峥.临床风湿病学[J].上海:上海科学技术出版社,1999:207-209.
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