Abstract：Objective: To investigate the correlation between pathological types of lupus nephritis (LN) and laboratory indicators and clinical features. Methods: A total of 406 patients with LN who were admitted to our hospital from January 2020 to February 2023 were selected as the research subjects. LN was divided into six types, including I, II, III, IV, V, and composite types, of which the composite type was II + V, III + V, and IV + V. The relationship between LN clinical classification and pathological type, LN clinical manifestations and pathological type, LN activity score and pathological type, and LN pathological activity index and clinical indicators were analyzed. Results: Among the 406 patients with LN, 273 cases (67.24%) were of renal onset type, which was the highest, and the incidence rates of types II, IV, V, and composite type were higher than that of type III (P<0.05). The incidence rate of asymptomatic type II was higher than that of types IV, V, and composite type (P<0.05). The incidence rate of nephritic syndrome in type III was higher than that in type IV (P<0.05). The incidence rates of nephrotic syndrome in types IV, V, and composite type were higher than that in type II (P<0.05). The incidence rate of renal insufficiency in type IV was higher than that in type II (P<0.05). The detection rates of hypertension in types IV and composite type were significantly higher than those in other types (P<0.05). The incidence rate of hematuria in type IV was higher than that in other types (P<0.05). The incidence rates of hypoproteinemia and massive proteinuria in types V, IV, and composite type were higher than those in types II and III (P<0.05). The level of serum creatinine in type IV was higher than that in other types (P<0.05). The incidence rate of anemia in type IV was higher than that in other types (P<0.05). The positive rates of anti-dsDNA antibody in different pathological types were statistically different (P<0.05), and the positive rate of anti-dsDNA antibody was the lowest in type V and the highest in type IV. The detection rate of low C3 was higher in type IV than in other types (P<0.05). The detection rates of low C3 and low C4 were lower in type V than in other types (P<0.05). Compared with other types, the AI and SLEDAI scores in type IV were the highest (P<0.05). Compared with other types, the CI score in the composite type was the highest (P<0.05). AI was negatively correlated with platelet count, C3, and C4, and positively correlated with 24Upro and SLEDAI (P<0.05). Serum creatinine was positively correlated with AI and CI (P<0.05). Conclusion: The proliferative type is the most common pathological type of LN, and the most common type is IV. The pathological type of LN is correlated with clinical features and laboratory indicators, which is worth considering in clinical practice.
李娟, 王利丽, 杨林. 狼疮性肾炎病理类型与实验室指标和临床特点关系研究[J]. 河北医学, 2024, 30(4): 660-664.
LI Juan, et al. A Study on the Correlation between Pathological Types of Lupus Nephritis and Laboratory Indicators and Clinical Features. HeBei Med, 2024, 30(4): 660-664.
[1] Rovin BH,Teng YKO,Ginzler EM,et al.Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1):a double-blind,randomised,multicentre,placebo-controlled,phase 3 trial[J].Lancet,2021,397(10289):2070-2080. [2] Rovin BH,Furie R,Teng YKO,et al.A secondary analysis of the Belimumab International Study in Lupus Nephritis trial examined effects of belimumab on kidney outcomes and preservation of kidney function in patients with lupus nephritis[J].Kidney Int,2022,101(2):403-413. [3] Weening JJ,D'Agati VD,Schwartz MM,et al.The classification of glomerulonephtitis in systemic lupus erythematosusrevisited[J].Kidney Int,2004,65(2):521-530. [4] Furie RA,Aroca G,Cascino MD,et al.B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis:a randomised,double-blind,placebo-controlled trial[J].Ann Rheum Dis,2022,81(1):100-107. [5] 万慧婷,吴琳,赵秀芬,等.不同病理类型狼疮性肾炎患者肾小球IgG亚型沉积特点及意义[J].山东医药,2020,60(19):82-84. [6] Chalhoub NE,Wenderfer SE,Levy DM,et al.International consensus for the dosing of corticosteroids in childhood-onset systemic lupus erythematosus with proliferative lupus nephritis[J].Arthritis Rheumatol,2022,74(2):263-273. [7] 杜孟茹,张丽华,吴晓梅,等.狼疮性肾炎患者外周血“双阴性”T细胞与疾病活动的关系[J].肾脏病与透析肾移植杂志,2021,30(5):407-413. [8] 李华锋,莫怡浩,曾敏,等.狼疮性肾炎患者血清LRG1、ROCK2表达与自身免疫抗体及疾病活动的相关性分析[J].中国中西医结合肾病杂志,2021,22(12):1067-1069. [9] 高丹,路漫漫.狼疮性肾炎患者临床病理特征及远期预后影响因素分析[J].中华实用诊断与治疗杂志,2022,36(1):59-63. [10] 严之桢,聂萍,郑旭州,等.狼疮性肾炎病理类型与临床表现及实验室指标的相关性[J].长春中医药大学学报,2018,34(1):162-165.
2024, Vol. 30 
冀公网安备13080202000677号