【摘要】 目的:探讨狼疮性肾炎(LN)患者临床表现与肾脏病理改变的关系。方法:分析有肾损害临床表现的临床狼疮性肾炎(OLN)组38例患者和无肾损害临床表现的亚临床狼疮性肾炎(SLN)组26例患者临床及肾脏病理结果。结果:OLN组患者SLEDAI评分明显高于SLN组患者(P<0.01),补体C3水平明显低于SLN患者(P<0.05),5项尿微量蛋白水平显著增高。肾脏病理结果证实全部SLE患者均有肾小球损害,OLN组以Ⅳ型LN为主,SLN组Ⅱ型LN多见。肾小管病变、肾间质炎性细胞浸润及纤维化在2组中的分布无显著性差异(P>0.05)。结论:无肾损害临床表现的SLE患者应尽早行肾活检明确SLN的诊断及病理类型,控制LN进展、延缓肾功能恶化。更多还原

【Abstract】 Objective: To explore the relationship between clinical features and renal pathological changes in patients with lupus nephritis(LN).Methods: Clinical features and renal pathological changes in 38 patients with overt lupus nephritis(OLN) and 26 patients with silent lupus nephritis(SLN) were analyzed.Results: Compared with SLN patients,in OLN patients,the SLEDAI score and the levels of microproteinuria were significantly higher(P<0.001,P<0.05),and the level of C3 in serum was significantly lower(P<0.005).Glomerular lesions were detected by renal biopsy in all patients with systemic lupus erythematosus(SLE).LN type Ⅳ and Ⅱ were the predominant lesions in OLN and SLN patients,respectively.There was no significant difference in the tubular damage,interstitial infiltration,and fibrosis between these 2 groups(P>0.05).Conclusion: SLE patients without clinical manifestations of LN should have renal biopsy as early as possible to establish the diagnosis of SLN and confirm the pathological changes for renal protection.更多还原