中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2009年
1期
73-74
,共2页
黄志清%梁东%许勇芝%黄萍萍
黃誌清%樑東%許勇芝%黃萍萍
황지청%량동%허용지%황평평
红斑狼疮,系统性%狼疮肾炎%病理学
紅斑狼瘡,繫統性%狼瘡腎炎%病理學
홍반랑창,계통성%랑창신염%병이학
Lupus erythematosus%Systemic%Lupus nephritis%Pathology
目的 探讨肾脏病理检查在非典型狼疮肾炎(LN)诊断中的意义.方法 对28例非典型LN患者的临床和病理资料进行回顾性分析.结果 28例患者肾活检前均未达到美国风湿病学会诊断标准,其中术前诊断为原发性肾病综合征21例,慢性肾炎4例,无症状性血尿2例,无症状性蛋白尿1例;所有病例经肾活检确诊为LN,病理分型为:Ⅱ型3例,Ⅲ型4例,Ⅳ型21例,Ⅴ型7例,Ⅳ型+Ⅴ型2例;临床表现为肾病综合征者肾脏病理分型多为Ⅴ型和Ⅳ型,慢性肾炎综合征者病理分型呈多样化,隐匿性肾炎综合征者病理分型主要为Ⅱ型和Ⅲ型.结论 非典型LN临床表现无特异性,结合肾病理检查对非典型LN的诊断具有重要意义.
目的 探討腎髒病理檢查在非典型狼瘡腎炎(LN)診斷中的意義.方法 對28例非典型LN患者的臨床和病理資料進行迴顧性分析.結果 28例患者腎活檢前均未達到美國風濕病學會診斷標準,其中術前診斷為原髮性腎病綜閤徵21例,慢性腎炎4例,無癥狀性血尿2例,無癥狀性蛋白尿1例;所有病例經腎活檢確診為LN,病理分型為:Ⅱ型3例,Ⅲ型4例,Ⅳ型21例,Ⅴ型7例,Ⅳ型+Ⅴ型2例;臨床錶現為腎病綜閤徵者腎髒病理分型多為Ⅴ型和Ⅳ型,慢性腎炎綜閤徵者病理分型呈多樣化,隱匿性腎炎綜閤徵者病理分型主要為Ⅱ型和Ⅲ型.結論 非典型LN臨床錶現無特異性,結閤腎病理檢查對非典型LN的診斷具有重要意義.
목적 탐토신장병리검사재비전형랑창신염(LN)진단중적의의.방법 대28례비전형LN환자적림상화병리자료진행회고성분석.결과 28례환자신활검전균미체도미국풍습병학회진단표준,기중술전진단위원발성신병종합정21례,만성신염4례,무증상성혈뇨2례,무증상성단백뇨1례;소유병례경신활검학진위LN,병리분형위:Ⅱ형3례,Ⅲ형4례,Ⅳ형21례,Ⅴ형7례,Ⅳ형+Ⅴ형2례;림상표현위신병종합정자신장병리분형다위Ⅴ형화Ⅳ형,만성신염종합정자병리분형정다양화,은닉성신염종합정자병리분형주요위Ⅱ형화Ⅲ형.결론 비전형LN림상표현무특이성,결합신병리검사대비전형LN적진단구유중요의의.
Objective To explore the clinical value of renal biopsy in the diagnosis of atypical lupus nephri-tis(LN). Methods The clinical and renal pathological data of 28 cases with atypical LN were analyzed retrospective-ly. Results All 28 patients could not fulfill the ACR diagnostic criterion,misdiagnosed as primary nephritic syndrome 21 eases,chronic glomerulone-phritis syndrome 4 cases ,asymptomatic hematuria 2 cases and asymptomatic proteinuria 2 cases,all renal biopsy showed changes consistent to lupus nephritis,pathological types:3 cases were class Ⅱ,4 cases were class Ⅲ,21 cases were class Ⅳ ,7 cases were class Ⅴ,2 cases was class Ⅳ+ Ⅴlupus nephritis,the clinical manifestations of nephritic syndrome were mostly pathological type Ⅳ and Ⅴ, the chronic glomerulonephritis syndrome showed diversification of pathological type, asymptomatic hematuria and/or proteinuria were mostly pathological type Ⅱ and Ⅲ. Conclusion clinical manifestations of atypical LN is no specific and easy to be misdiagnosed. Renal bi-opsy has great value in the diagnosis of atypical LN.