Gan H C, Hyoon K, Fong K Y
Department of Medicine, National University Hospital, Lower Kent Ridge Road, Singapore 119074.
Singapore Med J. 2002 Dec;43(12):614-6.
To review the clinical outcomes of Systemic Lupus Erythematosus (SLE) patients with biopsy-proven lupus nephritis with regards to the histological features and treatment.
Patients (1) with SLE, (2) had renal biopsy in NUH for lupus nephritis, and (3) on follow-up from the period of January 1998 to April 2001, were reviewed.
Fifty patients were reviewed with female to male ratio of 4:1. Mean age was 35.4 years. Sixty-eight percent had renal involvement at diagnosis of SLE. At least 50% had other major organ systems involvement. Forty-two patients had WHO Class IV lupus nephritis. Biopsy showed crescents in 17 patients, microangiopathy in 19, and vasculitis in two patients. All patients received prednisolone. Forty-one had IV cyclophosphamide, two had oral cyclophosphamide and seven had cyclosporin A. Azathioprine was used in 41 patients, pulse methylprednisolone in eight, IVIG in four, plasma exchange in three and mycophenolate in two patients.
Forty-four percent were in complete remission, 26% in partial remission, 34% had relapsed nephritis, 4% had chronic renal failure and 12% progressed to ESRD. There were five deaths.
Renal involvement in SLE occurs early in the disease and is associated with other organ systems involvement. Only 44% were in complete remission. Thirty-four percent had relapsed. Renal survival was 88% in this cohort.
回顾经活检证实为狼疮性肾炎的系统性红斑狼疮（SLE）患者的临床结局，包括组织学特征和治疗情况。
对以下患者进行回顾性研究：（1）患有SLE；（2）在新加坡国立大学医院进行肾活检确诊为狼疮性肾炎；（3）在1998年1月至2001年4月期间接受随访。
共回顾了50例患者，男女比例为4:1。平均年龄为35.4岁。68%的患者在SLE诊断时已有肾脏受累。至少50%的患者有其他主要器官系统受累。42例患者为WHO IV级狼疮性肾炎。活检显示17例患者有新月体形成，19例有微血管病变，2例有血管炎。所有患者均接受泼尼松龙治疗。41例接受静脉环磷酰胺治疗，2例接受口服环磷酰胺治疗，7例接受环孢素A治疗。41例患者使用硫唑嘌呤，8例使用甲泼尼龙冲击治疗，4例使用静脉注射免疫球蛋白，3例进行血浆置换，2例使用霉酚酸酯。
44%的患者完全缓解，26%部分缓解，34%的患者肾炎复发，4%的患者出现慢性肾衰竭，12%的患者进展为终末期肾病。有5例死亡。
SLE患者的肾脏受累在疾病早期出现，并与其他器官系统受累相关。仅有44%的患者完全缓解。34%的患者复发。该队列的肾脏生存率为88%。
