狼疮性肾炎重复肾活检22例临床分析

【作者】 李涯松； 杨程德； 宋欣伟； 马红珍；

【机构】 浙江省中医院风湿科； 上海仁济医院风湿科；

【摘要】 目的探讨复发性狼疮性肾炎的病理变化特点和预后判断。方法收集有重复肾活检的复发性或治疗无效的狼疮性肾炎病例共22例,行治疗前、后两次肾活检病理类型变化及相关因素分析。结果 22例病人中,病理类型发生变化者11例(50％),其中6例转变为Ⅴ型,5例转变为Ⅳ型;病理类型变化、肾功能失代偿患者的比例在初次肾活检后治疗完全缓解、部分缓解和无效三组中均依次递增;不同治疗方案在病理类型变化、肾功能失代偿患者的比例方面可能有差别。结论复发性狼疮性肾炎肾脏病理类型变化是常见的,病理类型变化与临床治疗方案及临床治疗效果可能有一定关系,并提示预后不良。更多还原

【Abstract】 Objective: to study the kidney histopathologic character of the relapsing lupus nephritis and evaluate its prognosis. Methods: 22 patients of relapsing or inefficacious lupus nephritis who experienced repeated renal biopsy were Investigated. And then, We have analysed their kidney histopathologic type hange and related factor on the basis of two biopsy around。 Results: It revealed that there were 11 of 22 patients(50%) whose pathologic type had been transformed, and 6 of 11 patients whose pathologic type transformed to class V of LN, and 5 of 11 patients whose pathologic type transformed to class Ⅵ of LN. the proportion of histopathologic type change and renal function decompensation increased in proper order on patients completely alleviated or partial remission or ineffective after first kidney biopsy,with。 Different treatment probably be correlated on histopathologic type change and renal function decompensation。 Conclusion: pathologic type transmutation is common in patients with relapsing lupus nephritis, it is correlated with clinical treatment program and therapeutic effect, and prognose poor diagnosis。更多还原