Ginzler E M
State University of New York Health Science Center, Brooklyn.
Curr Opin Rheumatol. 1991 Oct;3(5):780-8. doi: 10.1097/00002281-199110000-00006.
Although nephritis remains a very important clinical disease manifestation of systemic lupus erythematosus (SLE), the focus has shifted from issues of mortality to morbidity. An improved method for measuring renal function is presented, and the value of renal biopsy, specifically the chronicity index, is confirmed as a predictor of end-stage renal disease. Several studies detailing the generally favorable course in SLE patients with renal failure who have eventually required chronic dialysis or renal transplantation are discussed. A high frequency of cardiovascular manifestations, often subclinical, is documented, including abnormalities of ventricular and valvular function. The clinical course and response to treatment of SLE patients with diffuse interstitial lung disease and pulmonary hypertension are outlined. Cases of the unusual gastrointestinal presentation of protein-losing enteropathy in SLE have been described by several authors. The clinical correlates and significance of persistent rheumatoid-like arthritis and radiologic erosive and cystic bony lesions in SLE are discussed. Serologic markers of specific SLE disease manifestations and general predictors of disease activity are evaluated. Complications related to infection, malignancy, and pregnancy are described.
尽管肾炎仍是系统性红斑狼疮（SLE）非常重要的临床疾病表现，但关注点已从死亡率问题转向发病率问题。本文介绍了一种改进的肾功能测量方法，并确认肾活检的价值，特别是慢性指数，可作为终末期肾病的预测指标。文中还讨论了多项详细研究，这些研究涉及最终需要长期透析或肾移植的SLE肾衰竭患者总体良好的病程。记录显示心血管表现的发生率很高，且常为亚临床症状，包括心室和瓣膜功能异常。概述了SLE合并弥漫性间质性肺病和肺动脉高压患者的临床病程及治疗反应。多位作者描述了SLE患者出现蛋白丢失性肠病这种不寻常胃肠道表现的病例。讨论了SLE中持续性类风湿样关节炎以及放射学侵蚀性和囊性骨病变的临床关联及意义。评估了SLE特定疾病表现的血清学标志物和疾病活动的一般预测指标。描述了与感染、恶性肿瘤和妊娠相关的并发症。
