Gavrilov G
Vutr Boles. 1979;18(1):64-9.
Sixty six patients with lupus nephropathy with hypertonic syndrome are examined. In patients with latent (inactive) lupus glomerulonephritis hypertonic syndrome developed 3--8 months after the initiation of the corticosteroid treatment, advancing with fluctuations, in some of the patients the arterial pressure being normalized after the discontinuation of that treatment. In patients with chronic active lupus glomerulonephritis without nephrotic syndrome, the hypertension develops before the initiation of the corticosteroid treatment, fluctuating at the beginning, and gradually assumes a stable character 3--5 months after the beginning of such treatment, sometimes with a malignant course and rapid development of renal insufficiency. The hypertonic syndrome advances most severely and malignantly in chronic lupus glomerulonephritis with nephrotic syndrome and is resistant to the active antihypertensive treatment. In 18, out of 25, such patients, the hypertonic syndrome is manifested in parallel with nephropathy before the inclusion of the cortocosteroid treatment. The grave and malignant course of the hypertonic syndrome is associated with the peculiarities of the clinical form and histomorphological type of that lupus nephropathy. In the patients with nephrosclerosis, the hypertonic syndrome is with a gradually progressing evolution, in parallel with the progress of the renal insufficiency.
对66例患有狼疮性肾病并伴有高血压综合征的患者进行了检查。在患有隐匿性(非活动性)狼疮性肾小球肾炎的患者中,高血压综合征在开始使用皮质类固醇治疗后3 - 8个月出现,呈波动进展,部分患者在停止该治疗后血压恢复正常。在无肾病综合征的慢性活动性狼疮性肾小球肾炎患者中,高血压在开始皮质类固醇治疗前就已出现,起初波动,在开始治疗3 - 5个月后逐渐呈稳定状态,有时呈恶性病程且肾功能不全迅速发展。高血压综合征在伴有肾病综合征的慢性狼疮性肾小球肾炎中进展最为严重且呈恶性,对积极的降压治疗有抵抗性。在25例此类患者中,有18例在开始皮质类固醇治疗前,高血压综合征与肾病同时出现。高血压综合征的严重和恶性病程与狼疮性肾病的临床类型和组织形态学类型的特点有关。在患有肾硬化的患者中,高血压综合征随着肾功能不全的进展而逐渐进展。