目的:探讨狼疮肾炎(lupus nephritis,LN)患者肾小球滤过率(glomerular filtration rate,GFR)与其病理分型及临床指标的关系。方法:检测39例狼疮肾炎患者行肾活检前一周内的血清肌酐(Scr)、血尿素氮(BUN)、血清白蛋白、24h尿蛋白定量、补体C3、C4、抗双链DNA(dsDNA)抗体滴度、体重指标,同时记录患者年龄和SLEDAI积分,利用MDRD-7公式计算GFR。结果:LN各病理类型间Scr、BUN、GFR的差异均无统计学意义(P gt;0.05),血清白蛋白各病理类型间差异有统计学意义(p lt;0.05)。相关分析提示LN患者的24 h尿蛋白量与GFR存在负相关关系,相关系数(r=-0.330, P=0.040),LN患者的GFR与SLEDAI积分、补体C3、C4水平、抗dsDNA抗体滴度均未见明显相关性。结论:LN的病理分型结果不能代替GFR对肾功能的评估;LN患者24h尿蛋白定量一定程度上可以对肾功能做出评估;SLEDAI积分、C3、C4以及抗dsDNA抗体滴度水平不能反映患者肾脏损害程度。
Citation：
SHI Lianjie,LI Min,YANG Nanping,et al.. Investigation of the Relationship between Pathologic Type, Clinical Indicators and the Glomerular Filtration Rate of Lupus Nephritis Patients. West China Medical Journal, 2009, 24(8): 2078-2080. doi:
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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TAN E M, COHEN A S, FRIES J F, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus[J]. Arthritis Rheum, 1982, 25 (11): 1271-1277.
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HOCHER B, SCHWARZ A, REINBACHER D. Effects of endothelin receptor antagonists on the progression of diabetic nephropathy. NePhron,2001,87:161-169.
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唐琦,史浩,王伟铭,等.三种肾小球滤过率检测方法与勤TcDTPA清除率的比较与分析[J].中华肾病杂志,2005,21(10):589-592.
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LEVEY A S,BOSCH J P,LEWIS J B, et al.A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation, Modification Of Diet In Renal Disease Study Group[J]. Ann Intern Med,1999,130:461-470.
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- 1. TAN E M, COHEN A S, FRIES J F, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus[J]. Arthritis Rheum, 1982, 25 (11): 1271-1277.
- 2. 庄永泽,余英豪,郑智勇,等.狼疮性肾炎活动性指数和慢性化指数的临床意义[J].肾脏病与透析肾移植杂志,1996,5(5):22-25.
- 3. 沈克勤,俞雨生,唐政,等.狼疮性肾炎的远期预后[J].肾脏病与透析肾移植杂志,1996,3(5):14-19.
- 4. HOCHER B, SCHWARZ A, REINBACHER D. Effects of endothelin receptor antagonists on the progression of diabetic nephropathy. NePhron,2001,87:161-169.
- 5. 贾支俊,冯雪凤,郭利利,等.肾小球滤过率、血清肌酐及24h尿蛋白定量与狼疮肾炎病程相关性研究[J].实用医学杂志,2008,24(3):376-377.
- 6. 唐琦,史浩,王伟铭,等.三种肾小球滤过率检测方法与勤TcDTPA清除率的比较与分析[J].中华肾病杂志,2005,21(10):589-592.
- 7. LEVEY A S,BOSCH J P,LEWIS J B, et al.A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation, Modification Of Diet In Renal Disease Study Group[J]. Ann Intern Med,1999,130:461-470.
