狼疮性肾炎病理与临床特征相关性研究:49例报告

Pathological classification and clinical characteristics of lupus nephritis: a report of 49 cases

目的探讨狼疮性肾炎病理与临床活动性以及实验室检查的关系。方法对49例狼疮性肾炎患者进行肾活检及病理分型,分析各病理类型的临床活动性,实验室检查以及肾脏病理特点的关系。结果所有患者均有病理学异常,Ⅳ、Ⅴ型临床多表现为肾病综合症,而Ⅱ、Ⅲ型多以隐匿性肾炎为主要表现;NIH、BI指标不仅能反应病理损伤情况,且与临床重要指标之间具有显著相关性;几乎所有病理积分以及重要的临床指标均提示IV型狼疮的活动性较强。结论狼疮性肾炎的病理类型与临床活动性、实验室检查有一定联系;根据狼疮性肾炎的临床活动性积分、实验室检查可以大致推测其病理类型,估计肾损害的严重程度。

Objective To evaluate the relation between the pathological features of lupus nephritis （LN） and the clinical activity and laboratory examination. Methods Renal biopsies were obtained from 49 cases of lupus nephritis and classified according to ISN/RPS（2003） classification. The clinical activity, laboratory results and the renal pathological features of the disease were analyzed. Results All the cases showed pathologies in the kidney. Type IV and V LN cases had a high incidence of nephrotic syndrome, and type II and III cases frequently showed latent nephritis. The NIH index and biopsy index indicated the degree of pathological lesions and were significantly related to the clinical features. Nearly all the indexes including NIH index, biopsy index, the clinical activity and the laboratory examination suggested stronger activity of type IV LN than the other types. Conclusion The pathological changes, clinical activity and laboratory examination results of LN are related with each other. The clinical activity and laboratory examination of LN can be used to estimate the pathological type and degree of renal lesion in LN.