关于狼疮性肾炎肾小管间质病变的研究

A Study of Tubulointerstitial Lesions in Lupus Nephritis

目的探讨狼疮性肾炎(lupus nephritis,LN)肾小管间质病变(tubulointerstitial lesion,TIL)与患者临床特点及肾穿刺病理的相关性。方法收集2010年1月~2016年12月在笔者医院确诊LN的203例患者的临床及肾活检病理资料,分析TIL分级与患者临床特点、肾脏病理活动指数(AI)、慢性指数(CI)、LN病理分型的关系。结果 TIL分级与SCr、β2-MG呈正相关,与e GFR呈负相关(P均<0.01),TILⅢ级e GFR水平最低,血肌酐及尿β2-Mg最高;TIL分级与肾脏整体的AI评分、CI评分呈正相关(P<0.05);不同LN病理类型之间TIL评分差异有统计学意义(P<0.05),Ⅳ型评分高于Ⅱ、Ⅲ、Ⅴ型。结论 LN患者TIL分级与临床特点和病理参数有相关性,联合LN病理分型与TIL分级可较好地判断LN患者的临床病理特点,评估预后。

Objective To investigate the correlation between tubulointerstitial lesions and clinical features and pathological progress. Methods From Jan 2010 to Dec 2016, 203 cases of LN patients, diagnosed by renal biopsy in our hospital with very clinical and pathological data,were studied according to the relativity among the degree of tubulointerstitial lesions, the clinical feature, pathological activity index, chronic index and the pathological typing. Results EGFR in patients with grade TILⅢ was lowest, SCr and β2-Mg highest. TIL classification was positively correlated with AI and CI score. The difference of TIL score between different LN pathological types was statistically significant （P〈0.05）, and the score of type Ⅳ was higher than the other type, like Ⅱ, Ⅲ and Ⅴ. Conclusion The TIL classification of LN patients is related to clinical feature and pathological parameters. Combined with LN pathological classification and TIL classification. It is better to judge the clinical pathological characteristics of LN patients, and evaluate the prognosis.