肾活检病理参数对狼疮性肾炎患儿生存率和肾脏存活率的影响

Impact of renal biopsy pathological parameters on survival rate of children with lupus nephritis,and their renal survival rate

目的研究儿童狼疮性肾炎(LN)患者的肾活检(肾穿)病理参数对患者生存率(SR)和肾脏存活率(RSR)的影响。方法对67例做肾活检的儿童LN患者进行随访,按WHO关于LN的病理分型进行分类。用Kaplan-Maier曲线计算SR和RSR。用Cox比例风险模型分析肾穿病理参数对SR和RSR的独立预测价值。结果 Log-rank检验结果显示儿童LN患者不同病理组间患者SR和RSR的有显著性差异。多变量Cox逐步回归分析,CI指数>3对RSR的影响有显著的统计学差异。结论随着透析和肾移植的发展,直接死于肾衰竭的患者比例越来越少,儿童LN慢性肾衰竭后依靠透析生存良好。肾脏的慢性指数是RSR的独立危险因素。

Objective To assess the contribution of renal biopsy parameters to predicting the disease outcomes in children patients with lupus nephritis （LN）. Methods Sixty-seven cases of LN in children who had received biopsy were studied for the survival rate （SR） and renal survival rate （RSR）. Renal biopsy variables were assessed to determine whether they contributed additional predictive value for SR and RSR. Results The SR or RSR differences among the six WHO classes had statistical significance. Multivariate analysis showed that CI＆gt;3 had influence on the renal survival rate （RSR）. Conclusion With the development of dialysis and renal transplantation,the numbers of patient who direatly die of renal failure are becoming less and less,and chidren with lupus nephritis （LN） who developed chronic renal failure can have high survival rate by dialysis. The prognositic factors associated with the renal survival rate in chidren with lupus nephritis（LN） is CI.