中国寡免疫沉积型狼疮性肾炎患者的临床病理特征及预后：一项来自单中心的大型队列研究

Clinicopathological characteristics and outcomes of Chinese patients with scanty immune deposits lupus nephritis: a large cohort study from a single center.

作者信息

Li Qiuyu, Song Di, Wang Fengmei, Tan Ying, Yu Feng, Zhao Minghui

机构信息

Renal Division, Department of Medicine, Peking University First Hospital, Beijing 100034, China ; Institute of Nephrology, Peking University, Beijing 100034, China ; Key Laboratory of Renal Disease, Ministry of Health of China, Beijing 100034, China ; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing 100034, China.

出版信息

ScientificWorldJournal. 2014 Feb 4;2014:212597. doi: 10.1155/2014/212597. eCollection 2014.

DOI:10.1155/2014/212597

PMID:24672300

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3932248/

Abstract

OBJECTIVE

To assess clinicopathological characteristics of lupus nephritis patients with scanty immune deposits.

METHODS

The data of patients with scanty immune deposits lupus nephritis were retrospectively analyzed. Plasma ANCA and complement components were detected.

RESULTS

Among 316 cases with renal biopsy-proven lupus nephritis, 40 cases were diagnosed as scanty immune deposits. There were significantly higher value of serum creatinine (P = 0.002) and lower hemoglobin level (P = 0.009) and higher score of cellular crescents (P = 0.015) in scanty immune deposits group compared with immune complex deposits group. The frequency of positive plasma ANCA was significantly higher in scanty immune deposits group than that in immune complex deposits group (52.5% versus 10.1%, P < 0.001). As for comparisons of plasma complement components, there were significantly higher levels of C1q (P = 0.005) and Bb (P = 0.02) and lower level of factor H (P = 0.003) in scanty immune deposits group. The ratio of treatment failure was significantly higher in scanty immune deposits group than that in immune deposits group (42.5% versus 19.20%, P = 0.001). The renal outcomes were similar between the two groups.

CONCLUSIONS

Patients with scanty immune deposits lupus nephritis had more severe kidney damage. ANCA and activation of complement alternative pathway might be involved in the pathogenesis of the disease.

摘要

目的

评估免疫沉积物较少的狼疮性肾炎患者的临床病理特征。

方法

回顾性分析免疫沉积物较少的狼疮性肾炎患者的数据。检测血浆抗中性粒细胞胞浆抗体（ANCA）和补体成分。

结果

在316例经肾活检证实的狼疮性肾炎患者中，40例被诊断为免疫沉积物较少。与免疫复合物沉积组相比，免疫沉积物较少组的血清肌酐值显著更高（P = 0.002），血红蛋白水平更低（P = 0.009），细胞性新月体评分更高（P = 0.015）。免疫沉积物较少组血浆ANCA阳性频率显著高于免疫复合物沉积组（52.5% 对10.1%，P < 0.001）。至于血浆补体成分的比较，免疫沉积物较少组的C1q（P = 0.005）和Bb（P = 0.02）水平显著更高，因子H水平更低（P = 0.003）。免疫沉积物较少组的治疗失败率显著高于免疫沉积组（42.5% 对19.20%，P = 0.001）。两组的肾脏结局相似。