【摘要】 目的　研究狼疮性肾炎（ＬＮ）病人的长期生存率，并分析影响生存率的预后因素。方法　对１９８６年１２ 月～１９９６ 年１２ 月住院的３２６ 例ＬＮ病人进行回顾性分析，用寿命表分析生存率，采用Ｃｏｘ 模型分析预后因素。结果　ＬＮ病人１，５，１０ ａ 生存率分别为８８－３ ％ ，７４－５％ 及６０－２％ 。影响生存率的预后因素有高血压、浆膜炎，血清肌酐≥１２０ μｍｏｌ／Ｌ，系统性红斑狼疮疾病活动指数（ＳＬＥＤＡＩ） ≥２０ 分，尿细胞管型，Ｃ３ ＜ ０．８ ｇ／Ｌ及合并感染，其中血清肌酐升高，Ｃ３ 下降，ＳＬＥＤＡＩ≥２０ 分是独立的预后影响因素。激素加环磷酰胺治疗能提高生存率。结论　肾脏受损，Ｃ３ 下降及狼疮活动程度是影响ＬＮ预后的重要因素，积极的免疫抑制剂治疗有利于改善预后。更多还原

【Abstract】 Objective To investigate the survival probability and predictors of death in patients with lupus nephritis (LN). Methods 326 patients who were admitted into and diagnosed as LN at our hospital from Dec. 1986 to Dec. 1996 were studied retrospectively. Survival proabilities were studied with life list and predictors of death were analyzed with the Cox model. Results The overall survival probabilities at 1,5 and 10 years after diagnosis were 88.3%, 74.5% and 60.2%. respectively. Hypertension, serositis, serum creatinine≥120 μmol/L, SLE disease activity index (SLEDAI)≥20 scores, complement C 3<0.8 g/L and infection were prediction factors for mortality, among which increased serum creatinine and decreased complement C 3 and SLEDAI≥20 scores were independent factors significantly associated with low survival probability. Prednisone plus cyclophosphamide could improve survival. Conclusion Renal abnormalities and high lupus activity index and decreased conplement C 3 are the most important survival predictors in LN patients. Active immunosuppresive therapy can improve the prognosis of LN.更多还原