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伴有狼疮性肾炎的家族性系统性红斑狼疮患者的临床病理特征

Clinicopathological characteristics of familial SLE patients with lupus nephritis.

作者信息

Wang Z, Tang Z, Zhang H T, Hu W X, Liu Z H, Li L S

机构信息

Nanjing University School of Medicine, Research Institute of Nephrology, Jinling Hospital, Nanjing, China.

出版信息

Lupus. 2009 Mar;18(3):243-8. doi: 10.1177/0961203308097447.

Abstract

This study aimed to analyze the clinicopathological characteristics of familial SLE patients with lupus nephritis (LN). A total of 136 Chinese patients with lupus nephritis diagnosed by renal biopsy, including 34 familial patients and 102 sporadic cases, were recruited. Their demographic information, age of onset, disease duration, clinical features, laboratory data and histological manifestations were compared. The first-degree relatives (17 sibling cases and eight parent-offspring cases) of familial SLE patients were primarily affected. The prevalence of fever, rash and arthritis in familial subjects was higher than that in sporadic subjects. Familial patients had lower platelet counts and higher low-density lipoprotein. In familial patients, class V lupus nephritis was less common. After adjusted with the Benjamini and Hochberg procedure, however, fever was the only feature occurring significantly and more frequently in familial patients (58.8% vs 26.5%, P = 0.001). Moreover, SLEDAI and other clinicopathological features did not differ significantly between the two groups. Multivariate analysis showed that a higher prevalence of fever was an independent predictor of familial SLE. Most clinicopathological features in familial SLE patients were not significantly different from those in sporadic patients; the severity of LN in familial SLE patients was similar to that of sporadic cases. Thus, familial SLE may not be a different clinical entity.

摘要

本研究旨在分析家族性狼疮性肾炎(LN)患者的临床病理特征。共纳入136例经肾活检确诊的狼疮性肾炎中国患者,其中包括34例家族性患者和102例散发性病例。比较了他们的人口统计学信息、发病年龄、病程、临床特征、实验室数据和组织学表现。家族性SLE患者的一级亲属(17例同胞病例和8例亲子病例)受影响最为严重。家族性患者中发热、皮疹和关节炎的发生率高于散发性患者。家族性患者的血小板计数较低,低密度脂蛋白较高。在家族性患者中,Ⅴ型狼疮性肾炎较少见。然而,经Benjamini和Hochberg方法校正后,发热是家族性患者中唯一显著且更频繁出现的特征(58.8%对26.5%,P = 0.001)。此外,两组间SLEDAI及其他临床病理特征无显著差异。多因素分析显示,发热的较高发生率是家族性SLE的独立预测因素。家族性SLE患者的大多数临床病理特征与散发性患者无显著差异;家族性SLE患者LN的严重程度与散发性病例相似。因此,家族性SLE可能并非一个不同的临床实体。

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