552例SLE患者肾脏受损的临床及实验室检查结果分析
发布时间：2018-11-12 21:07
【摘要】：目的 通过系统回顾分析13年间系统性红斑狼疮(systemic lupus erythematosus, SLE)伴肾脏系统受累住院患者的临床表现、实验室检查及影像学检查,为及时诊断、及时治疗及改善SLE患者的预后提供临床依据。方法 回顾性分析1990年1月至2013年1月在昆明医科大学第二附属医院诊断明确、资料完整的1029例SLE住院患者,对有肾脏系统损伤的552例患者临床表现、实验室检查、影像学检查进行统计分析。结果1.1990年1月-2013年1月住院治疗的SLE患者1029例,其中符合狼疮肾炎(lupus nephritis, LN)诊断标准的患者399例(38.78%),男47例,女352例(男：女=1：7.49)。有肾损害未达到LN标准的153例(12.15%),男19例,134例(男：女=1：7.05)。无肾脏损害组477例(46.36%),男45例,女432例(男：女=1：9.60)。3组间性别比率无明显差异(P=0.263)。三组患者的好发年龄均在30～40岁,女性患病率远高于男性,有肾损害的患者发病年龄较轻,平均年龄(32.25土13.34岁),病程较短,平均病程为43.38土5.25月。2.SLE患者临床有肾脏损害表现552例(53.7%),行肾脏活检LN患者的病理分型中,Ⅳ型最为多见38例(43.7%),且肾脏损害表现最突出。3.SLE有肾脏损害表现者抗核小体抗体阳性率显著高于无肾脏损害表现者,且ds-DNA抗体滴度明显增高,其中Ⅳ型ds-DNA抗体阳性率、抗SSA抗体阳性率明显高于其他类型(P0.05)。4. SLEDAI评分以LN组最高(10.86±0.26),差异有显著性(P0.000)。5.多因素Logistic回归分析提示血红蛋白和补体与SLEDAI呈负相关；高龄、病情活动、补体C3水平重度降低者肾功能损害重、病理分型较严重；而低龄、病情稳定、补体正常或轻度降低者,肾功能损害较轻,病理分型较轻。结论SLE常累及肾脏,LN的临床表现和实验室指标与其病理类型存在一定的联系,根据临床表现和实验室指标可以在一定程度上评估LN的严重程度,但是仍不能替代肾活检在LN病理诊断中的重要价值。
[Abstract]:Objective to analyze the clinical manifestations, laboratory and imaging findings of systemic lupus erythematosus (systemic lupus erythematosus, SLE) patients with renal system involvement during the past 13 years. Timely treatment and improvement of the prognosis of patients with SLE provide clinical basis. Methods from January 1990 to January 2013, a total of 1029 SLE patients with definite diagnosis and complete data were analyzed retrospectively. The clinical manifestations and laboratory findings of 552 patients with renal system injury were analyzed. The imaging examination was analyzed statistically. Results 1. 1029 SLE patients were admitted from January 1990 to January 2013, including 399 patients (38.78%) who met the (lupus nephritis, LN) diagnostic criteria for lupus nephritis, 47 males and 352 females (male: female = 1: 7.49). There were 153 cases (12.15%) with kidney damage below LN standard, 19 cases were male, 134 cases (male: female = 1: 7.05). There were 477 cases (46.36%) without renal damage, 45 males and 432 females (males: females = 1: 9.60). The predilection age of the three groups was 30 to 40 years old. The prevalence rate of female was much higher than that of male. The average age (32.25 卤13.34 years) of the patients with renal damage was lower, and the course of disease was shorter. The average course of disease was 43.38 卤5.25 months. There were 552 cases (53.7%) with renal damage in 2.SLE patients, 38 cases (43.7%) were type 鈪，
本文编号：2328217
[Abstract]:Objective to analyze the clinical manifestations, laboratory and imaging findings of systemic lupus erythematosus (systemic lupus erythematosus, SLE) patients with renal system involvement during the past 13 years. Timely treatment and improvement of the prognosis of patients with SLE provide clinical basis. Methods from January 1990 to January 2013, a total of 1029 SLE patients with definite diagnosis and complete data were analyzed retrospectively. The clinical manifestations and laboratory findings of 552 patients with renal system injury were analyzed. The imaging examination was analyzed statistically. Results 1. 1029 SLE patients were admitted from January 1990 to January 2013, including 399 patients (38.78%) who met the (lupus nephritis, LN) diagnostic criteria for lupus nephritis, 47 males and 352 females (male: female = 1: 7.49). There were 153 cases (12.15%) with kidney damage below LN standard, 19 cases were male, 134 cases (male: female = 1: 7.05). There were 477 cases (46.36%) without renal damage, 45 males and 432 females (males: females = 1: 9.60). The predilection age of the three groups was 30 to 40 years old. The prevalence rate of female was much higher than that of male. The average age (32.25 卤13.34 years) of the patients with renal damage was lower, and the course of disease was shorter. The average course of disease was 43.38 卤5.25 months. There were 552 cases (53.7%) with renal damage in 2.SLE patients, 38 cases (43.7%) were type 鈪，
本文编号：2328217
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