男性狼疮性肾炎50例临床与病理分析

LUPUS NEPHRITIS IN MALE ADULTS ,AN ANALYSIS OF THE CLINICAL AND PATHOLOGICAL FEATURES

为提高对男性狼疮性肾炎（ＬＮ）的认识，减少临床误、漏诊，对５０例男性ＬＮ的临床、病理与预后分析，并与女性ＬＮ匹配对比。结果男性ＬＮ起病年龄较晚，肾脏病变发生率高且重（Ｐ＜０．０１），肾脏病理以Ⅳ、Ⅴ型较女性多见，Ⅱ型较女性少见。大量蛋白尿、血肌酐升高较女性常见（Ｐ＜０．０５）。临床表现主要为发热、皮疹、关节痛。皮疹、肝大、神经、精神障碍男性多于女性。随访１～１２年，男性ＬＮ改善，好转率较女性低，而复发、病死率较女性高。

ystemic lupus erythematosus is an uncommon disease in men, The clinical and pathological features and prognosis in 50 male patients with lupus nephritis (LN)and 50 agematched female patients with LN were analysed.The age at which the disease began and the diagnosis was made was generally older in the male. The incidence of LN was higher in the male than in female (P<0.01).The incidence of types IV and V LN was more common in the male than in female. Type II LN was not found in male patients. Pro-teinuria over 3. 5g/24h and renal failure were more common in the male than in female(P<0.05).The three most common clinical manifestations in male patients were irregular fever,skin rashes and painful joints. Rashes, hepatomegaly and neuropsychiatric dysfunction were more common in the male than in fe-male,The patients were followed up one to twelve years, The rate of recovery and improvement was low-er,but that of relapse and mortality higher in the male than in female.