| 黄雯静,刘倩,王英,孟晓燕.狼疮肾炎肾小管间质损伤的临床分析[J].实用中西医结合临床,2018,18(12): |
| 狼疮肾炎肾小管间质损伤的临床分析 |
| Clinical Analysis of Renal Tubulointerstitial Injury in Lupus Nephritis |
| 投稿时间：2018-11-02 修订日期：2018-11-02 |
| DOI： |
| 中文关键词: 狼疮肾炎 肾小管间质 |
| 英文关键词: lupus nephritis renal tubulointerstitial injury prognosis clinical analysis |
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| 中文摘要: |
| 【】 目的：探讨狼疮肾炎肾小管间质损伤的临床病理情况及其影响患者预后改善的分析。方法：回顾分析2013年9月1日至2016年5月31日期间于广西柳州市工人医院肾内科经肾活检确诊为狼疮肾炎的300例患者的临床资料。根据2003年国际标准重新进行病理分型后,分别计算各型狼疮肾炎小管间质损伤类型的发生率,运用秩和检验分析不同病变类型肾小管间质损伤的差异,以及发生IV型病理转型的狼疮肾炎转型前后肾小管间质损伤的差异。结果：间质炎细胞浸润的发生率最高(86.5%),其次为间质纤维化(66.9%)和肾小管萎缩(66.5%),而肾小管上皮细胞变性发生率为55.1%。肾小管间质损伤程度不一(P<0.05),Ⅱ型(无TIL及轻度TIL占89.5%)和Ⅴ型(无TIL及轻度TIL占81.08%)肾小管间质损伤程度明显轻于Ⅲ型(无TIL及轻度TIL61%)和Ⅳ型(无TIL及轻度TIL占48.7%),但Ⅲ型和Ⅳ型间差异无统计学意义(P＞0.05)。结论：各型狼疮肾炎患者都较容易出现肾小管间质损伤的情况,但其损伤程度会有差异。肾小管间质损伤程度不影响 IV 型狼疮肾炎的病理转型, 且病理转型前后肾小管间质损害改变不明显。肾小管间质损伤可影响患者的预后,损伤越重预后越差。 |
| 英文摘要: |
| Objective: To investigate the clinical and pathological features of renal tubulointerstitial injury and its influence on the prognosis of lupus nephritis. Methods: The clinical data of 300 patients with lupus nephritis confirmed by renal biopsy in the nephrology department of Liuzhou Worker"s Hospital of Guangxi from September 1, 2013 to May 31, 2016 were reviewed and analyzed. After the pathological classification was reclassified in accordance with international standards in 2003, the incidence of tubulointerstitial injury in various types of lupus nephritis was calculated, the difference of tubulointerstitial injury in different types of lupus nephritis was analyzed by rank sum test and the difference of tubulointerstitial injury before and after lupus nephritis with type IV pathological transformation was analyzed. Results: The incidence of interstitial inflammatory cell infiltration was the highest (86.5%), followed by interstitial fibrosis(66.9%) and renal tubule atrophy(66.5%), while the incidence of renal tubular epithelial degeneration was 55.1%. The renal tubulointerstitial damage was also found (P<0.05). Type II (no TIL and mild TIL accounted for 89.5%) and type V (no TIL and mild TIL 81.08%) were significantly lighter than type III (no TIL and mild TIL61%) and type IV (no TIL and 48.7% mild TIL), but there was no statistical difference between type III and type IV types (P > 0.05). Conclusion: all kinds of lupus nephritis patients are more likely to have tubulointerstitial injury, but the degree of injury is different. The degree of tubulointerstitial injury does not affect the pathological transformation of lupus nephritis type IV, and the change of tubulointerstitial lesion is not obvious before and after pathological transformation. Renal tubulointerstitial injury can affect the prognosis of patients. The worse the injury is, the worse the prognosis is. |
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