Sui Manshu, Jia Xibei, Yu Chengyuan, Guo Xiaofang, Liu Xiaogang, Ji Ying, Mu Suhong, Wu Hongchi, Xie Rujuan
Department of Nephrology, First Affiliated Hospital of Harbin Medical University, Harbin, PR China.
Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, PR China.
Cent Eur J Immunol. 2014;39(2):243-52. doi: 10.5114/ceji.2014.43730. Epub 2014 Jun 27.
The purpose is to evaluate the relationship between hypoalbuminemia, hyperlipidemia, nephrotic and renal severity in patients with lupus nephritis.
Autoantibodies and serological parameters were measured and analyzed in 429 patients with lupus nephritis in a single centre.
The prevalence for anti-dsDNA, anti-nucleosome and anti-histone was higher in the nephrotic syndrome (NS) patients than that in non-NS patients (p < 0.0001 for all comparisons). The NS patients had a higher proportion of diffuse proliferative renal lesions (69.05%) and membranous lesions (68.00%). Serum total cholesterol and albumin levels were associated with activity and severity of renal disease. The levels of proteinuria and serum albumin were positively correlated with activity and chronicity index (p < 0.001 for all correlations). The incidence of a poor renal outcome (p = 0.0461) in the NS patients was significantly increased. On the other hand, the remission rate (p = 0.0002) was significantly reduced and recurrence rate (p = 0.0027) was significantly increased in NS patients.
This paper highlights that nephrotic-range proteinuria, elevated total cholesterol level and decreased serum albumin levels may reflect the activity and severity of renal damage in SLE patients.
本研究旨在评估狼疮性肾炎患者低白蛋白血症、高脂血症、肾病及肾脏严重程度之间的关系。
在单一中心对429例狼疮性肾炎患者的自身抗体和血清学参数进行测量及分析。
肾病综合征(NS)患者中抗双链DNA、抗核小体及抗组蛋白的患病率高于非NS患者(所有比较p<0.0001)。NS患者中弥漫性增殖性肾损害(69.05%)和膜性损害(68.00%)的比例更高。血清总胆固醇和白蛋白水平与肾脏疾病的活动度和严重程度相关。蛋白尿水平和血清白蛋白水平与活动度和慢性指数呈正相关(所有相关性p<0.001)。NS患者肾脏不良结局的发生率显著增加(p=0.0461)。另一方面,NS患者的缓解率显著降低(p=0.0002),复发率显著升高(p=0.0027)。
本文强调肾病范围蛋白尿、总胆固醇水平升高及血清白蛋白水平降低可能反映系统性红斑狼疮患者肾脏损害的活动度和严重程度。