70例男性系统性红斑狼疮患者临床及肾脏病理分析

Clinical and Renal Pathological Analysis of Seventy Male Patients with Systemic Lupus Erythematosus

目的:探讨男性系统性红斑狼疮(SLE)患者的临床及肾脏病理特点。方法:回顾性分析了我院2003年4月～2009年4月收治的70例男性SLE患者的临床表现及肾脏病理,并对部分患者进行了随访。结果:70例男性SLE患者年龄16岁～72岁,平均(34.8±14.1)岁,临床表现肾病综合征25例、慢性肾炎19例、急性肾衰竭8例、隐匿性肾炎14例,以及尿常规检查和肾功能正常者4例。42例患者进行了肾活检,肾脏病理结果为Ⅱ型3例、Ⅲ型5例、Ⅳ型20例、Ⅴ型5例,Ⅲ+Ⅴ型4例,Ⅳ+Ⅴ型5例。在肾病综合征患者中21例进行了肾活检的,病理类型分别为Ⅲ型1例、Ⅳ型9例、Ⅴ型4例、Ⅲ+Ⅴ型2例、Ⅳ+Ⅴ型5例;在8例急性肾衰竭患者中,7例进行了肾活检,病理均为Ⅳ型。结论:男性SLE在各个年龄段均可患病,临床和肾脏病理表现多样,多数患者病情较重,但也有部分患者肾脏损害较轻。

Objective：To explore the clinical manifestations and renal pathologic characteristics in male patients with systemic lupus erythematosus （SLE）.Methods：Seventy male SLE patients admitted to our hospital from April 2003 to April 2009 were retrospectively studied.Results：The average age of the seventy male SLE patients was 34.8±14.1 in year （16～72 in years）.Clinical renal manifestations of SLE in these males were：25 with nephritic syndrome,19 with chronic glomerulonephritis,8 with acute renal failure （ARF）,14 with latent glomerulonephritis,and 4 with normal routine urine test and renal function.Renal pathological types of 42 patients with renal biopsy showed：3 cases of type Ⅱ,5 type Ⅲ,20 type Ⅳ,5 type Ⅴ,4 of type Ⅲ＋Ⅴ,5 of type Ⅳ＋Ⅴ.Renal pathological types of 21 cases with nephritic syndrome were：1 type Ⅲ,9 type Ⅳ,4 type Ⅴ,2 type Ⅲ＋Ⅴ,5 type Ⅳ＋Ⅴ.Out of all 8 cases with ARF,7 received renal biopsy and all were presented as type Ⅳ.Conclusion：Male SLE patients may present in various stages of age.The clinical manifestations and pathological types of the male SLE patients were with multiplicity.Serious renal injuries can be found in most male SLE patients,but in some patients the renal injury seemed to be mild.