迟发型狼疮肾炎35例临床与肾脏病理特点

Clinical and pathological features of patients with late-on set lupus nephritis

目的分析迟发型狼疮肾炎（LOLN）患者的临床与肾脏病理特点。方法选择发病年龄≥50岁的经临床和（或）肾活检病理诊断为狼疮肾炎（LN）的患者35例为观察组，选取同期发病年龄〈50岁的LN患者50例为对照组。回顾性分析LOLN患者的临床与肾脏病理特点。结果观察组年龄大于对照组（P〈0．05），高血压、肾功能损害、贫血、肺间质病变发生率高于对照组（P〈O．05或P〈0．01）；光敏感、面部红斑及口腔溃疡的发生率低于对照组（P〈0．01）；肾脏病理类型分布与对照组无差异（P〉0．05），但在病理特点上以慢性化病变为主；血清免疫学方面，观察组抗SSA抗体阳性率较对照组高（P〈0．01）。结论LOLN患者临床表现不典型，容易漏诊，临床上对年龄大于50岁，合并贫血、肺间质病变及肾脏损害的患者应警惕LOLN。

Objective To analyze the clinical and pathological features of patients with late-onset lupus nephritis （LOLN）. Methods Thirty-five LN patients who had disease onset at the age of ≥50 were as observation group. Fifty LN patients who had disease onset at the age of %50 were as control group. The clinical and pathological features were compared between two groups. Results The age, hypertension, renal insufficiency, anemia, lung interstitial changes in observation group were much more than that in control group （P〈0. 05）. Chronic change were common in observation group（P〈0. 05 or P〈0. 01）, however, the renal histological subtypes showed no significant difference between two group（P〉0. 05）. Anti-SSA antibody were more common in observation group （P〈 0. 01 ）. Conclusions The clinical manifestation of patients with LOLN are untypical and easy to leakiness,to those who had renal lesions, anemia, lung interstitial changes onset at the age of ≥50 should on guard aginst LOLN.