Mitjavila F, Pac V, Moga I, Poveda R, Vidaller A, Carrera M, Pujol R
Department of Internal Medicine, Ciutat Sanitària i Universitària de Bellvitge, Barcelona, Spain.
Clin Exp Rheumatol. 1997 Nov-Dec;15(6):625-31.
To define prognostic factors at the moment of the diagnosis in lupus nephritis, and to assess the contribution of renal histologic data.
Sixty-two patients with systemic lupus erythematosus (SLE) and histologic evidence of nephritis were studied for renal outcome. Correlations between clinical or biological and histological data were carried out as an indicator of the utility of the renal biopsy.
There were no significant differences in creatinine between the different histologic classes at the moment of the diagnosis, although the WHO classification correlated well with proteinuria and immunologic activity. There was a strong correlation between clinical and histological activity as measured by the activity index in proliferative glomerulonephritis, mainly with creatinine and proteinuria, but not with haematuria or immunological activity. Young age at the time of renal biopsy, proliferative classes III and IV, and the chronicity index were associated with a poorer renal prognosis.
High immunologic activity, mainly elevated anti-DNA titers and decreased levels of CH100, is highly suggestive of proliferative glomerulonephritis. Proliferative classes III and IV and high chronicity indexes are associated with a worse prognosis in lupus nephritis.
确定狼疮性肾炎诊断时的预后因素，并评估肾脏组织学数据的作用。
对62例患有系统性红斑狼疮（SLE）且有肾炎组织学证据的患者进行肾脏预后研究。将临床或生物学数据与组织学数据进行相关性分析，以此作为肾活检效用的指标。
诊断时不同组织学类型之间的肌酐水平无显著差异，尽管世界卫生组织（WHO）分类与蛋白尿和免疫活性密切相关。通过增殖性肾小球肾炎活动指数衡量的临床与组织学活动之间存在强相关性，主要与肌酐和蛋白尿相关，但与血尿或免疫活性无关。肾活检时年龄较小、增殖性III级和IV级以及慢性指数与较差的肾脏预后相关。
高免疫活性，主要是抗DNA滴度升高和CH100水平降低，高度提示增殖性肾小球肾炎。增殖性III级和IV级以及高慢性指数与狼疮性肾炎的预后较差相关。
