狼疮性肾炎不同病理分型的疾病活动性及终末期肾病的危险因素分析

吴奇俊; 张东梅; 翟志芳; 宋志强

doi:10.16016/j.1000-5404.202007102

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狼疮性肾炎不同病理分型的疾病活动性及终末期肾病的危险因素分析

临床医学 | 更新时间：2026-01-09

- 狼疮性肾炎不同病理分型的疾病活动性及终末期肾病的危险因素分析
- Disease activity of lupus nephritis with different pathological types and risk factors of end-stage renal disease: analysis of 305 cases
- 第三军医大学学报 2020年43卷第23期页码：2336-2340
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院皮肤科
- 作者简介：
  
  [宋志强，E-mail: drsongzq@hotmail.com SONG Zhiqiang, E-mail:drsongzq@hotmail.com
- 基金信息：
  
  国家自然科学基金面上项目(81673068);国家自然科学基金面上项目(81773316)
- DOI：10.16016/j.1000-5404.202007102
  中图分类号： R181.32;R446.8;R593.242
- 收稿：2020-07-11，
  
  修回：2020-09-30，
  
  纸质出版：2020-12-15
- 稿件说明：
移动端阅览
吴奇俊, 张东梅, 翟志芳, 等. 狼疮性肾炎不同病理分型的疾病活动性及终末期肾病的危险因素分析[J]. 第三军医大学学报, 2020,43(23):2336-2340.

Qijun WU, Dongmei ZHANG, Zhifang ZHAI, et al. Disease activity of lupus nephritis with different pathological types and risk factors of end-stage renal disease: analysis of 305 cases[J]. Journal of Third Military Medical University, 2020, 43(23): 2336-2340.
吴奇俊, 张东梅, 翟志芳, 等. 狼疮性肾炎不同病理分型的疾病活动性及终末期肾病的危险因素分析[J]. 第三军医大学学报, 2020,43(23):2336-2340. DOI： 10.16016/j.1000-5404.202007102.

Qijun WU, Dongmei ZHANG, Zhifang ZHAI, et al. Disease activity of lupus nephritis with different pathological types and risk factors of end-stage renal disease: analysis of 305 cases[J]. Journal of Third Military Medical University, 2020, 43(23): 2336-2340. DOI： 10.16016/j.1000-5404.202007102.

摘要

目的

分析狼疮性肾炎(lupus nephritis，LN)患者不同病理分型与临床疾病活动性和预后的关系，以及终末期肾病(end-stage renal disease

ESRD)的危险因素。

方法

回顾性分析本院2013-2018年经肾活检确诊的305例LN患者，按肾脏病理分为毛细血管内细胞增多性LN(包括LN-Ⅲ/Ⅳ146例、合并膜性病变的LN-Ⅲ/Ⅳ+Ⅴ106例)和非毛细血管内细胞增多性LN(LN-Ⅱ/Ⅴ53例)，比较不同病理分型患者的疾病活动性和预后的差异，通过回归分析探索ESRD的危险因素。

结果

与LN-Ⅱ/Ⅴ相比，LN-Ⅲ/Ⅳ(伴或不伴LN-Ⅴ)患者SLEDAI评分≥10分比例更高(66.3%

45.3%)，且出现浆膜炎、脱发、贫血、血肌酐增高、血尿、ESRD以及抗ds-DNA、AnuA抗体阳性的比例均更高(

0.05)。ESRD整体累积发病率为14.4%，LN-Ⅲ/Ⅳ(伴或不伴LN-Ⅴ)是ESRD的独立危险因素(

值为2.977)，此外，抗dsDNA抗体阳性、血肌酐增高、SLEDAI评分≥10分亦为ESRD的独立危险因素(

值分别为1.722、5.484、2.070)。不同病理类型患者的生存时间分布差异无统计学意义(

0.05)。

结论

LN-Ⅲ/Ⅳ(伴或不伴LN-Ⅴ)型患者表现出更高的疾病活动性，肾脏和肾外损害更重，进展为ESRD的风险更高。

Abstract

Objective

To explore the relationship of lupus nephritis (LN) with different pathological types with disease activity and prognosis

and investigate the risk factors of end-stage renal disease (ESRD).

Methods

A total of 305 pathologically-confirmed LN patients admitted in our hospital from the year of 2013 to 2018 were retrospectively enrolled in this study. According to the results of renal biopsy

they were divided into mesangial hypercellularity LN (including 146 cases of LN-Ⅲ/Ⅳ and 106 cases of LN-Ⅲ/Ⅳ+Ⅴ) and non-mesangial hypercellularity LN (53 cases of LN-Ⅱ/Ⅴ). The disease activity and prognosis of the patients with different pathological types were compared

and the risk factors of ESRD were explored.

Results

There were more patients with Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) ≥10 (66.3%

45.3%)

occurrences of serositis

hair loss

anemia

higher serum creatinine

hematuria

and ESRD

and manifestations of anti-dsDNA antibody and anti-AnuA antibody in the LN-Ⅲ/Ⅳ patients (with or without LN-Ⅴ) than the LN-Ⅱ/Ⅴ patients (

0.05). The cumulative incidence of ESRD was 14.4%

and LN-Ⅲ/Ⅳ(with or without LN-Ⅴ)

as well as anti-dsDNA antibody

higher serum creatinine

and SLEDAI ≥10

was identified as independent risk factors for ESRD (

=2.977

1.722

5.484

2.070). But there was no statistical difference in survival time among different pathological types (

0.05).

Conclusion

The LN-Ⅲ/Ⅳ patients (with or without LN-Ⅴ) have higher disease activity

severer impairment both in inside and outside of the kidney

and higher risk of progression to ESRD.

关键词

Keywords

references

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