狼疮肾炎的病理与临床关系探讨

Relation between lupus nephritis and its clinical manifestation

目的 探讨狼疮肾炎的病理改变与临床的联系。方法 对 47例系统性红斑狼疮肾炎患者行肾活检 ,并进行病理分型 ,分析各病理类型的临床特点。结果 Ⅱ、Ⅲ、Ⅳ型狼疮肾炎常呈现出临床活动 ,Ⅴ型临床上呈现非活动状态 ;Ⅳ型血尿、肾功能不全发生率高 ,Ⅴ型主要表现为大量蛋白尿。肾脏病理急性活动指数与系统性红斑狼疮的临床活动指数及抗dsDNA抗体滴度无相关性。结论 狼疮肾炎的病理改变与临床表现有一定联系 ,但二者之间不平衡。

Objective To investigate the relation between pathologic features of lupus nephritis (LN) and its clinical findings.Methods The renal biopsy was made in 47 systemic lupus erythematosus (SLE) patients and 6 types were classified.Then the correlation between pathological features and clinical findings was analysed.Results Ⅱ,Ⅲ and Ⅳ type LN was often clinically active,but Ⅴ type LN was inactive.In Ⅳ type LN,there was high incidence of hematuria and renal insufficiency.On the other hand,severe proteinuria was found in Ⅴ type LN.There was no relation between acute activity index of renal pathology and SLE clinical activity index. The same result was found in renal pathological acute activity index and anti-dsDNA antibody levels.Conclusion There is a relation between LN pathological change and SLE clinical manifestation,but their degrees are different.