【摘要】 目的对比分析LN患者肾脏活检和相关实验室检测结果,探讨分析LN的病理类型和患者临床表现和临床评分的关系。方法回顾分析2007年1月至2012年1月近5年于我院就诊的50例系统性红斑狼疮(SLE)的病例资料,所有患者均进行了实验室常规检查、影像学检查以及肾脏活检等检测项目,根据光镜检查结果将患者肾脏病变进行分级和评分,对不同病理类型之间进行对比分析。结果肾炎综合征患者占28%,肾病综合征患者占50%,肾功能不全患者占5.2%。TIL为0者以Ⅱ和Ⅳ型居多,为1级者以Ⅳ型居多,为2、3级者以Ⅳ型居多。各型LN中,2-3和0-1级相比较病程较长(P<0.05)。随着TIL级数增加,肾活检血Cr水平也增加,二者呈正相关。尿蛋白含量分析显示1、2级比0、3级含量高,不同病理类型LN的AI、CI、TIL参数比较Ⅳ型LN的AI评分最高和其他类型比较差异显著P<0.05;CI值以Ⅵ型最高,其次为Ⅳ型和Ⅴ型;TIL值以Ⅵ型最高,其次为Ⅳ型和Ⅲ型。Ⅳ型血尿蛋白含量和尿发生率均比较高,P<0.05,其肾功能不全发生率和其他类型比较较高,其血Cr水平也明显高于其他类型P<0.05。结论Ⅲ型和Ⅱ型LN患者多表现为肾炎综合征。肾病综合征常见于Ⅳ型和Ⅴ型LN患者中,表现为高蛋白尿和低蛋白血症,也会出现肾功能不全和高血压。更多还原

【Abstract】 Objective Comparative analysis of the LN patients kidney biopsy and laboratory test results,relationship of analysis LN pathological type and clinical performance and clinical score. Methods A retrospective analysis from January 2007 to January 2012 in the last five years in this hospital,50 patients with systemic lupus erythematosus( SLE) cases,all patients underwent routine laboratory examination( urine,blood,plasma protein,erythrocyte sedimentation rate,serum lipid concentrations,plasma protein electrophoresis,24- hour urinary protein excretion,immunological tests,etc.),imaging( including echocardiography,chest X- ray,abdominal ultrasound,etc.) as well as kidney biopsy test items,according to the light microscopic examination results in patients with kidney disease classification and ratings,comparative analysis between the different types of pathology. Results Nephritic syndrome patients accounted for 28%( mainly Ⅲ and Ⅱ),accounting for 50% of patients with nephrotic syndrome( main type Ⅴ),patients with renal insufficiency accounted for 5. 2%( type Ⅲ based). TIL 0 Ⅱ and Ⅳ type mostly,for one,opt for the type IV,grade 2 and 3 by the majority of typeⅣ. 2- 3 and 0- 1 in the various types of LN compared to a longer course( P < 0. 05). With the increase in TIL series,renal biopsy blood Cr levels also increased,both were positively correlated. Urinary protein content analysis showed that 1,2 level than the 0,3 level content,different pathological types of LN AI,CI,of TIL parameters Ⅳ LN’s AI highest scores and other types significant difference P< 0. 05; CI value to Ⅵ type highest,followed by the type Ⅳ and V type; TIL value type Ⅵ highest followed by type Ⅳ and ⅲ type.Ⅳ the hematuria protein content and urine incidence rate is relatively high,relatively higher( P < 0. 05),renal insufficiency incidence and other types of blood Cr levels were also significantly higher than the other types of P < 0. 05. Conclusion III type and type II LN patients showed nephritic syndrome. Nephrotic syndrome is common in type Ⅳ and Ⅴ LN patients showed high proteinuria and hypoproteinemia will appear renal insufficiency and hypertension.更多还原