狼疮性肾炎虚、实主证与疾病活动的相关性探讨

Correlation of Disease Activity with Primary Syndromes of Deficiency and Excess Types of Lupus Nephritis

【目的】探讨狼疮性肾炎(LN)主证型的虚、实证与疾病活动的相关性。【方法】回顾性研究收集确诊的LN患者134例,按中医辨证分为虚证组及实证组,比较2组患者反映疾病活动性的相关指标包括系统性红斑狼疮病情活动度(SLEDAI)计分、补体、炎症指标及尿液指标等的差异。【结果】纳入研究的患者中,实证组33例,虚证组101例。SLEDAI计分方面,实证组中9.09%处于非活动期,而虚证组为4.95%,其余均处于活动期,且2组均以重度活动期为主。2组SLEDAI计分比较,差异无统计学意义(P>0.05)。2组患者的补体C3、C4及炎症指标C反应蛋白(CRP)、血沉(ESR)等比较,差异均无统计学意义(P>0.05)。2组患者的尿蛋白及尿隐血比较,差异亦无统计学意义(P>0.05)。【结论】LN患者虚、实主证与疾病活动并无相关性,虚证患者绝大部分亦处于疾病活动期,而并非缓解期。

Objective To explore the correlation of disease activity with the primary syndromes of deficiency and excess types of lupus nephritis（LN）. Methods A retrospective study was carried out in 134 LN patients,and the LN patients were differentiated into deficiency syndrome（deficiency group） and excess syndrome（excess group）.The disease activity related indicators of systemic lupus erythematosus disease activity index（SLEDAI） scores,complements, inflammation indexes, and urine indicators were compared between the two groups. Results Of the 134 LN patients,33 cases were differentiated into excess syndrome,and 101 cases were differentiated into deficiency syndrome. According to the SLEDAI scores, 9.09% of the patients in excess group were inactive,4.95% of the patients in deficiency group were inactive, and most of the patients in the two groups were at severe active stage. There was no significant difference of SLEDAI scores between the two groups（P 0.05）. The differences of complement C3 and C4, inflammation indexes of C-reactive protein（CRP） and erythrocyte sedimentation rate（ESR）,urine protein,and urine occult blood were also insignificant between the two groups（P 0.05）. Conclusion There is no correlation between deficiency-excess syndrome differentiation and disease activity of LN. Most of the LN patients with deficiency syndrome are at active stage,but not at remission stage.