CAJ | 학술논문

目的：探讨不同病理类型狼疮性肾炎（LN）的临床表现、实验室及免疫学特征。方法：回顾性分析147例不同病理类型 LN 的临床表现、实验室及免疫学指标，并进行统计学分析比较。结果：（1）LN 最常见临床表现为浮肿73例（49．7%）、关节炎66例（44．9）%和皮疹65例（44．2）%，而Ⅲ型 LN 患者浮肿及脱发比例较Ⅳ型高，差异有统计学意义（P ﹤0．05）；（2）Ⅳ型 LN 的血肌酐，WBC、Hb、PLT 损伤较Ⅴ型重、补体更低，平均动脉压比Ⅴ型高，差异有统计学意义（P ﹤0．05）；Ⅴ型的胆固醇、三酰甘油较Ⅲ型和Ⅳ型明显升高；Ⅴ＋Ⅲ型尿蛋白较突出，较Ⅲ型和Ⅳ型明显高，差异均有统计学意义（P ﹤0．05）；（3）自身抗体在 LN 中阳性率较高的依次为 ANA 126例（85．7%），抗- dsDNA 90例（61．2%），抗- SSA 89例（60．5%）；而Ⅴ＋Ⅲ型及Ⅴ＋Ⅳ型抗- U1RNP 阳性率分别为10例（90．9%）和11例（68．7%），较Ⅲ型和Ⅳ型明显高，差异有统计学意义（P ﹤0．05）。结论：本组病例以Ⅳ型 LN 为主；不同病理类型 LN 各具一些临床、实验室及免疫学特征；浮肿是 LN最常见的临床表现；复合Ⅴ型患者抗- U1RNP 阳性率较高。应注意Ⅴ型复合型的临床、免疫特征，可能预示发病机制不同，指导临床诊治，判断预后。
목적：탐토불동병리류형랑창성신염（LN）적림상표현、실험실급면역학특정。방법：회고성분석147례불동병리류형 LN 적림상표현、실험실급면역학지표，병진행통계학분석비교。결과：（1）LN 최상견림상표현위부종73례（49．7%）、관절염66례（44．9）%화피진65례（44．2）%，이Ⅲ형 LN 환자부종급탈발비례교Ⅳ형고，차이유통계학의의（P ﹤0．05）；（2）Ⅳ형 LN 적혈기항，WBC、Hb、PLT 손상교Ⅴ형중、보체경저，평균동맥압비Ⅴ형고，차이유통계학의의（P ﹤0．05）；Ⅴ형적담고순、삼선감유교Ⅲ형화Ⅳ형명현승고；Ⅴ＋Ⅲ형뇨단백교돌출，교Ⅲ형화Ⅳ형명현고，차이균유통계학의의（P ﹤0．05）；（3）자신항체재 LN 중양성솔교고적의차위 ANA 126례（85．7%），항- dsDNA 90례（61．2%），항- SSA 89례（60．5%）；이Ⅴ＋Ⅲ형급Ⅴ＋Ⅳ형항- U1RNP 양성솔분별위10례（90．9%）화11례（68．7%），교Ⅲ형화Ⅳ형명현고，차이유통계학의의（P ﹤0．05）。결론：본조병례이Ⅳ형 LN 위주；불동병리류형 LN 각구일사림상、실험실급면역학특정；부종시 LN최상견적림상표현；복합Ⅴ형환자항- U1RNP 양성솔교고。응주의Ⅴ형복합형적림상、면역특정，가능예시발병궤제불동，지도림상진치，판단예후。
Objective:To explore the clinical、pathological and immunological features with different pathological types of lu-pus nephritis(LN)patients. Methods:The clinical、pathological and immunological material of 147 cases with LN were analyzed ret-rospectively and was analyzed by statistical method. Results:(1)The most common clinical symptoms of LN included was edema 73 cases(49. 7% ),arthralgia 66cases(44. 9% )and rash 65 cases(44. 2% ). Compared to other class LN,class Ⅲ had higher inci-dence of edema and hair loss,the difference was statistically significant(P ﹤ 0. 05);(2)Compared to class Ⅴ,the class Ⅳ had more severely changed on the average Crea,WBC,HGB,PLT ,and moer lower complement levels,more higher MAPmean arterial pres-sure,the difference was statistically significant(P ﹤ 0. 05);Compared to class Ⅲ and Ⅳ,the averge cholesteroland triglycerides lev-els of classⅤ was significantly higher(P ﹤ 0. 05),24 h urinary protein excretion of classⅤ + Ⅲ was more higher(P ﹤ 0. 05);(3) The positive rates of autoantibodies in LN patients were relatively high level on ANA 126 cases(85. 7% ),anti - dsDNA 90 cases (61. 2% ),anti - SSA 89 cases(60. 5% );compared with classⅢ and classⅣ,class Ⅴ + Ⅲ and class Ⅴ + Ⅳ anti - U1RNP posi-tive rates were significantly higher,Respectively was 10 cases(90. 9% )and 11 cases(68. 7% ),the difference was statistically sig-nificant(P ﹤ 0. 05). Conclusion:LN class Ⅳ was the most common type in this study;The LN with different pathological class has some of the characteristics of clinical,laboratory and immunological features;Edema is the most common clinical symptoms on LN;LN Complex Ⅴ has more higher anti - U1RNP positive rates than others. We should pay attention to the clinical,immunological char-acteristics of complex class Ⅴ,It may indicate different pathogenesis,and guide clinical diagnosis and treatment,judge prognosis.