狼疮性肾炎非肾衰与肾衰的临床分析

Clinical Analysis of Non-renal Failure and Renal Failure of Lupus Nephritis

将６４例狼疮性肾炎（ＬＮ）分为非肾衰组与肾衰组，观察两组自身抗体、补体、狼疮带试验（ＬＢＴ）、肾活检及预后。结果显示，肾衰组自身抗体（特别是ｄｓ－ＤＮＡ和ＳＭ）与补体（Ｃ３、ＣＨ５０）明显较非肾衰组低（Ｐ＜０．０５）；ＬＢＴ阳性率两组无显著性差异（Ｐ＞０．０５），但都较同组自身抗体阳性率高；肾活检两组各型均可见。另外肾衰组死亡率明显较非肾衰组高（Ｐ＜０．０１）。因此，（１）肾衰患者如自身抗体阴性，不能排除ＬＮ的诊断，应反复多次复查血清免疫学，及早做ＬＢＴ及肾活检，可避免ＬＮ漏诊或误诊。（２）ＬＮ并肾衰是ＬＮ的主要死亡原因。

Sixty-four patients of lupus nephritis (LN) were classfied into two groups :the non-renal failure group and renal failure group, and their anti-bodies, complements, renal biopsy, lupus band teat(LBT) and prognosis wereinvestigated. The result showed that the an-ti-bodies (especially ds-DNA and SM)and complements (C 3,CH 50 )in the renal failure group were lower than those of the non-renal failure group (P<0.05). The differnce of LBT positive rate between the two groups was not significant (P>0.05)but higher than the positive rate of self anti-bodies in each in each individual group. Every type of renal pathology existed in both groups. Death rate of renal failure group was higher than non-renal failure group(P<0.01)。It was concluded that 1) if the anti-bodies of a patientwese negative, there is a possibility of LN, thus their serum immunology should be examed repeatedly, so that he must have LBT and renal biopsy test at an early stage in order to prevent from not diagnosedor misdiagnosis, 2) LN-with renal failure is the main factor contributing to the death of LN pa-tients.