狼疮肾炎患者肾小球滤过率与病理分型、临床指标关系的探讨

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、24 h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〉0.05）,血清白蛋白各病理类型间差异有统计学意义（P〈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24 h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。

Investigation of the Relationship between Pathologic Type,Clinical Indicators and the Glomerular Filtration Rate of Lupus Nephritis Patients

Objective：To explore the relationship between pathologic type of lupus nephritis（LN） and glomerular filtration rate（GFR）,the relationship between pathologic type of LN and clinical indicators.Methods：Serum creatinine,blood urea nitrogen,plasma albumin,24 hours urine protein,C3,C4,anti-dsDNA antibody titer,body weight of 39 patients were measured who intended to have a renal biopsy in the coming week and their age and SLEDAI score were recorded and MDRD-7 equation was used to reckon the GFR.Results：There were no significant differences in serum creatinine, blood urea nitrogen and GFR in all pathological types （P 〉0.05） in the 39 patients with LN and there were significant differences in plasma albumin （P 〈0.05） ; Through correlation analysis, there were negative correlation between the 24 hours urine protein and GFR （r= -0. 330, P=0. 040） ,but no correlation with C3, C4, anti-dsDNA antibody titer and SLEDAI score. Conclusion： Pathological types of LN can＇t replace GFR on the evaluation of renal function; 24 hours urine protein of the LN can, to some extent, evaluate the renal function; The level of SLEDAI score, C3, C4 and anti-dsDNA antibody can not reflect the degree of kidney damage.