狼疮性肾炎血清抗中性粒细胞胞浆抗体阳性患者的临床表现和病理特征及预后分析

Analysis of clinical manifestations,pathological features and prognosis of patients with positive serum antineutrophil cytoplasmic antibody in lupus nephritis

目的分析狼疮性肾炎(LN)血清抗中性粒细胞胞浆抗体(ANCA)阳性患者的临床表现、病理特征及预后。方法选取2018年11月至2020年10月于本院治疗的30例LN血清ANCA阳性患者作为ANCA阳性组,另选取同期于本院治疗的30例LN血清ANCA阴性患者作为ANCA阴性组。比较两组临床资料、实验室指标、病理结果、预后结果。结果ANCA阳性组狼疮活动度指数(SLEDAI)评分、光过敏及皮损、面部红斑发生率均高于ANCA阴性组,差异有统计学意义(P<0.05)。ANCA阳性组的白细胞计数、血红蛋白、补体C_(3)均低于ANCA阴性组,红细胞沉降率高于ANCA阴性组,差异有统计学意义(P<0.05)。ANCA阳性组慢性指数(CI)评分、肾小球硬化、新月体形成率高于ANCA阴性组,差异有统计学意义(P<0.05)。ANCA阳性组尿蛋白转阴率低于ANCA阳性组,差异有统计学意义(P<0.05)。结论LN血清ANCA阳性患者光过敏及皮损、面部红斑发生率较高,疾病活动性强、肾脏可逆程度差,临床应及时采取有效治疗,以改善患者病情及预后。

Objective To analyze the clinical manifestations,pathological features and prognosis of patients with positive serum antineutrophil cytoplasmic antibody(ANCA)in lupus nephritis(LN).Methods 30 patients with positive LN serum ANCA treated in our hospital from November 2018 to October 2020 were selected as the ANCA positive group,and 30 patients with negative LN serum ANCA treated in our hospital during the same period were selected as the ANCA negative group.The clinical data,laboratory indicators,pathological results,prognostic results were compared between two groups.Results The systemic lupus erythematosus disease activity index(SLEDAI)score,the incidence of photosensitivity,skin lesions and facial erythema in the ANCA positive group was significantly higher than those in the ANCA negative group,the difference was statistically significant(P<0.05).The white blood cell count,hemoglobin and complement C_(3) in the ANCA positive group were lower than those in the ANCA negative group,and the red blood cell sedimentation rate was higher than that in the ANCA negative group,the differences were statistically significant(P<0.05).The chronic index(CI)score,glomerulosclerosis and crescent formation rate in the ANCA positive group were higher than those in the ANCA negative group,and the differences were statistically significant(P<0.05).The urine protein negative conversion rate in the ANCA positive group was lower than that in the ANCA positive group,and the differences were statistically significant(P<0.05).Conclusion The incidence of photoallergy,skin lesions and facial erythema in patients with positive LN serum ANCA is high,the disease activity is strong,and the degree of renal reversible is poor.Effective treatment should be taken in time to improve the condition and prognosis of patients.