血清抗中性粒细胞胞质抗体阳性狼疮性肾炎患者的临床病理特征及预后

发布时间：2018-04-25 20:39

  本文选题：狼疮性肾炎 + 抗中性粒细胞胞质抗体　； 参考：《肾脏病与透析肾移植杂志》2017年01期

【摘要】：目的:回顾性分析血清抗中性粒细胞胞质抗体(ANCA)阳性狼疮性肾炎(LN)患者的临床、病理特征及预后。方法:收集本中心1985年1月至2008年12月间明确诊断为血清ANCA阳性LN患者,回顾性分析其临床、病理特征及预后,对照组选取同期诊断为血清ANCA阴性LN患者。结果:符合入选标准的49例患者中,38例MPO-ANCA阳性,7例PR3-ANCA阳性,4例MPO-ANCA和PR3-ANCA双阳性。女性40例、男性9例。中位年龄33岁。ANCA阳性LN患者,尿沉渣红细胞计数、血清肌酐、SLE-DAI评分均高于对照组(P0.05);病理类型以LN-Ⅳ型为主,占61.22%;光镜下AI、CI评分均显著高于对照组(P0.05)。ANCA阳性LN患者中,20例接受吗替麦考酚酸酯(MMF)诱导治疗,18例接受静脉环磷酰胺(CYC)诱导治疗,其余11例患者接受雷公藤多苷等治疗MMF组的完全缓解率(90.00%vs 55.56%,P=0.027)和肾脏生存率(P=0.039)均优于CYC组。ANCA阳性LN患者中位随访87.83月,有7例患者(14.29%)发生终末期肾病,均为MPO-ANCA阳性。结论:血清ANCA阳性LN患者肾脏表现为大量的血尿、肾功能损害明显。这部分患者接受MMF诱导治疗,其完全缓解率和肾脏预后均优于CYC。
[Abstract]:Objective: to retrospectively analyze the clinical, pathological features and prognosis of patients with ANCA positive lupus nephritis. Methods: from January 1985 to December 2008, the patients with serum ANCA positive LN were collected and their clinical, pathological features and prognosis were analyzed retrospectively. The control group was diagnosed as serum ANCA negative LN at the same time. Results: of the 49 patients who met the inclusion criteria, 38 were MPO-ANCA positive, 7 were PR3-ANCA positive and 4 were MPO-ANCA and PR3-ANCA positive. There were 40 females and 9 males. The median age was 33 years old. ANCA positive LN patients had higher urinary sediment red blood cell count and serum creatinine SLE-DAI score than the control group (P 0.05), and the pathological type was mainly LN- 鈪，

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