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中国男性狼疮肾炎的临床病理特征与转归。

Clinicopathological characteristics and outcomes of male lupus nephritis in China.

机构信息

Renal Division, Department of Medicine, Peking University First Hospital, China.

出版信息

Lupus. 2012 Nov;21(13):1472-81. doi: 10.1177/0961203312458467. Epub 2012 Aug 16.

DOI:10.1177/0961203312458467
PMID:22898536
Abstract

OBJECTIVE

The objective of this article is to assess clinicopathological characteristics and outcomes of patients with male lupus nephritis in a cohort of Chinese patients.

METHODS

Clinical, pathological and outcome data of lupus nephritis patients with different gender were retrospectively analyzed and compared.

RESULTS

Among 315 patients with renal biopsy-proven lupus nephritis, 45 were male and 270 were female. The average ages of disease onset of the male and female patients were comparable. The interval between presentation of lupus nephritis and diagnosis was significantly longer in the male group than in female group (p = 0.003). Clinical presentation was similar except that males had a significantly lower proportion of alopecia (p = 0.005). In laboratory data, male lupus nephritis patients had higher hemoglobin (p = 0.023) and higher serum creatinine (p < 0.001) than female patients. As for pathological classification and index, no significant difference was found between the two groups. The male patients presented with significantly lower ratios of complete remission and partial remission, and higher ratios of treatment failure and relapse than the female group. Regarding long-term survival and renal outcome, male patients had significantly worse prognosis than females (p = 0.005).

CONCLUSIONS

The male lupus nephritis presented with later diagnosis, worse renal function, lower remission rate and higher relapse rate compared with female patients. The male patients had significantly higher mortality and poorer renal outcome.

摘要

目的

本文旨在评估中国患者队列中男性狼疮肾炎患者的临床病理特征和结局。

方法

回顾性分析和比较了不同性别狼疮肾炎患者的临床、病理和结局数据。

结果

在 315 例经肾活检证实的狼疮肾炎患者中,45 例为男性,270 例为女性。男性和女性患者的疾病发病年龄平均相近。男性组狼疮肾炎的表现与诊断之间的间隔明显长于女性组(p = 0.003)。临床表现相似,但男性脱发的比例明显较低(p = 0.005)。在实验室数据中,男性狼疮肾炎患者的血红蛋白(p = 0.023)和血清肌酐(p < 0.001)均高于女性患者。在病理分类和指标方面,两组间无显著差异。男性患者完全缓解和部分缓解的比例明显较低,治疗失败和复发的比例明显较高。在长期生存和肾脏结局方面,男性患者的预后明显差于女性(p = 0.005)。

结论

与女性患者相比,男性狼疮肾炎的诊断较晚,肾功能较差,缓解率较低,复发率较高。男性患者的死亡率和肾脏预后明显较差。

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