高血压对狼疮肾炎预后的影响

Influence of hypertension on prognosis of lupus nephritis

目的 研究高血压对狼疮肾炎 (LN)肾功能损害发展的影响。方法 对 5 33例成年LN病人采用回顾性群体研究。以LN发展到终末期肾病 (ESRD)的时间为衡量指标。采用寿命表分析研究高血压对LN患者肾功能发展到ESRD的影响。结果 5 33例患者平均随访时间为 7 8年 ,12 6例 (2 3 6 % )发展至ESRD。起病时伴随着高血压与ESRD的发展相关联。所有病例发展到ESRD的中位数时间分别为 ,重度高血压 (DBp >10 5mmHg) 8个月 ,轻度高血压 (DBp 90～ 10 4mmHg) 4 5个月 ,血压正常 112个月。多变量分析表明高血压独立影响着患者的预后 ,而患者的一般人口因素特点对ESRD的发展并无影响。结论 高血压是影响狼疮肾炎预后的重要的、潜在的可变因素。

Objective To determine the effect of hypertension on the development of end stage renal disease (ESRD) in patients with lupus nephritis.Method This retrospective cohort study followed an inception cohort of 533 adults with lupus nephritis.The outcome measure was the time of development to ESRD.Life table analysis was used to determine difference between patient subgroups in the time to development of ESRD.Results The median follow up time was 7 8 years,and there were 126 cases (23 6%) developed into ESRD among 553 patients.The median time to ESRD among patients with severe hypertension (diastolic blood pressure≥105 mm Hg) was 8 months,among patients with mild hypertension (diastolic blood pressure 90～104 mm Hg) it was 45 months and among normotensive patients it was greater than 112 months.The multivariable analyses demonstrated that the independent effects of hypertension result in shorter time to renal failure among LN patients with hypertension.Conclusion Hypertension appears to be an important potentially modifiable factor influencing the prognoses of patients with lupus nephritis.