狼疮肾炎例临床与病理分析精编

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1、狼疮肾炎60例临床与病理分析作者：金明，张虹作者单位：435332湖北薪春，薪春县第二人民医院【摘要】冃的探讨狼疮性肾炎病理类型与临床的关系，进而为临床病情的评估及治疗提供参考。方法冋顾性分析于2002—2009年就诊的60例狼疮肾炎患者临床表现与病理类型及相关实验室检测结果，病理分型按WHO1995年分型标准进行，分别进行活动性指数(AI)、慢性指数(CI)和肾小管间质病变(TIL)评分，同时分析LN病理活动指数与临床活动指数的相关性。结杲病理类型以IV型LN最多，占41.67%,其次是II型33.33%,V型和III型较少，分别占

2、13.33%和11.67%。II型与III型多表现为肾炎综合征，IV型和V型多表现为肾病综合征。蛋口尿以IV型和V型为重，跟II型比较差异有显著性，IV型LN的血尿、肾功能不全发生率、抗ds-DNA抗体阳性率最高，其AI亦显著高于其他类型,TIL评分和CI也较II型明显高。临床活动指数与病理活动性指数呈正相关。结论LN的病理改变与临床表现有一定的关系，根据其临床表现和实验室检查结果可大致推测其病理类型。【关键词】狼疮性肾炎;肾活检;病理分型;临床表现Clinicalandpathologicalanalysisof60caseswithlupus

3、nephritisJINMing,ZHANGHong.QichunSecondPeople'sHospital,Qichun435332,China[Abstract]ObjectiveToinvestigatelupusnephritis(LN)combinedwithrenalbiopsyandrelevantlaboratoryparameters,andprovidereferenceforassessingclinicalpatients*conditionandtherapy.Methods60patientswithLNadmitt

4、edduring2002—2009inhospitalwerecollectedandtheirdataofrenalbiopsyandroutinelaboratorytestswererecorded.PathologicalclassificationwasbasedonthestandardcriteriaofWHO1995,andscoredtheiractiveindex(AI),chronicindex(CI),tubularinterstitiallesion(TIL).Thenweanalyzedcorrelatio

5、nbetweenclinicalactivityindexandpathologicalactivityindex・ResultsTypeIVwasmostcommon(41.67%),type11(33.33%)wasnext,typeV(13.33%)and111(11.67%)werefewe匚TypeIIandIIIusuallymanifestedasnephritissyndrome,whiletypeIVandVmainlyasnephriticsyndrome.UrineproteininpatientswithTypeIVand

6、VLNwerehigherthaninpatientswithTypeIILN.TypeIVwasthemostactiveonewithaprevalenceofhematuria,renalinsufficiencyandanti-ds-DNAantibody.AlintypeIVwassignificantlyhigherthanothers*.CIandTILscoringintypeIVwasalsohigherthanintypeII.TherewasapositivecorrelationbetweenLNclinicalactiv

7、ityindexandpathologicalactivityindex.ConclusionsThereisrelationbetweenpathologicalchangeandclinicalmanifestationsoflupusnephritis;pathologicalclassificationcouldbeforetoldaccordingtotheclinicalmanifestationsandnecessarylaboratoryparameters.[Keywords]lupusnephritis;renalbiopsy

8、;pathologicalclassification;clinicalmanifestations系统性红斑狼疮(systemicWp