狼疮性肾炎且血清肌酐正常患者肾活检及临床变量的预后价值
Prognostic value of renal biopsy and clinical variables in patients with lupus nephritis and normal serum creatinine.
作者信息
Jacobsen S, Starklint H, Petersen J, Ullman S, Junker P, Voss A, Rasmussen J M, Tarp U, Poulsen L H, van Overeem Hansen G, Skaarup B, Hansen T M, Pødenphant J, Halberg P
机构信息
Department of Rheumatology at Copenhagen University Hospital at Hvidovre, Denmark.
出版信息
Scand J Rheumatol. 1999;28(5):288-99. doi: 10.1080/03009749950155464.
OBJECTIVE
To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI).
METHODS
Renal biopsies from 94 patients were re-assessed with regard to WHO class, activity, chronicity and tubulointerstitial indices without knowledge of clinical features. The outcome parameters were CRI defined as irreversibly increased serum creatinine and renal end stage disease.
RESULTS
The risk ratios (RR) of developing CRI were 2.6 for active urinary sediment, 3.1 for hyaline thrombi and 7.3 for glomerular leukocyte exudation. The RR of renal end stage disease was 5.0 when the duration of renal disease exceeded one year at the time of biopsy and 4.3 when biopsy disclosed a class IV lesion. Glomerular sclerosis was also associated to renal end stage disease.
CONCLUSION
Early renal biopsy and the abovementioned signs of active renal disease carry prognostic information that may have significant therapeutic implications.
目的
评估可能影响无慢性肾功能不全（CRI）的狼疮性肾炎患者肾脏转归的因素。
方法
对94例患者的肾活检标本重新评估世界卫生组织（WHO）分级、活动度、慢性化程度及肾小管间质指标，评估时不了解临床特征。转归参数为定义为血清肌酐不可逆升高的CRI和终末期肾病。
结果
出现CRI的风险比（RR），活动性尿沉渣为2.6，透明血栓为3.1，肾小球白细胞渗出为7.3。活检时肾病病程超过1年，终末期肾病的RR为5.0；活检显示为IV级病变时，RR为4.3。肾小球硬化也与终末期肾病相关。
结论
早期肾活检及上述活动性肾病迹象具有预后信息，可能具有重要的治疗意义。
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