本文選題：狼瘡性腎炎 + 抗中性粒細胞胞質(zhì)抗體�。� 參考：《腎臟病與透析腎移植雜志》2017年01期

【摘要】：目的:回顧性分析血清抗中性粒細胞胞質(zhì)抗體(ANCA)陽性狼瘡性腎炎(LN)患者的臨床、病理特征及預后。方法:收集本中心1985年1月至2008年12月間明確診斷為血清ANCA陽性LN患者,回顧性分析其臨床、病理特征及預后,對照組選取同期診斷為血清ANCA陰性LN患者。結(jié)果:符合入選標準的49例患者中,38例MPO-ANCA陽性,7例PR3-ANCA陽性,4例MPO-ANCA和PR3-ANCA雙陽性。女性40例、男性9例。中位年齡33歲。ANCA陽性LN患者,尿沉渣紅細胞計數(shù)、血清肌酐、SLE-DAI評分均高于對照組(P0.05);病理類型以LN-Ⅳ型為主,占61.22%;光鏡下AI、CI評分均顯著高于對照組(P0.05)。ANCA陽性LN患者中,20例接受嗎替麥考酚酸酯(MMF)誘導治療,18例接受靜脈環(huán)磷酰胺(CYC)誘導治療,其余11例患者接受雷公藤多苷等治療MMF組的完全緩解率(90.00%vs 55.56%,P=0.027)和腎臟生存率(P=0.039)均優(yōu)于CYC組。ANCA陽性LN患者中位隨訪87.83月,有7例患者(14.29%)發(fā)生終末期腎病,均為MPO-ANCA陽性。結(jié)論:血清ANCA陽性LN患者腎臟表現(xiàn)為大量的血尿、腎功能損害明顯。這部分患者接受MMF誘導治療,其完全緩解率和腎臟預后均優(yōu)于CYC。
[Abstract]:Objective: to retrospectively analyze the clinical, pathological features and prognosis of patients with ANCA positive lupus nephritis. Methods: from January 1985 to December 2008, the patients with serum ANCA positive LN were collected and their clinical, pathological features and prognosis were analyzed retrospectively. The control group was diagnosed as serum ANCA negative LN at the same time. Results: of the 49 patients who met the inclusion criteria, 38 were MPO-ANCA positive, 7 were PR3-ANCA positive and 4 were MPO-ANCA and PR3-ANCA positive. There were 40 females and 9 males. The median age was 33 years old. ANCA positive LN patients had higher urinary sediment red blood cell count and serum creatinine SLE-DAI score than the control group (P 0.05), and the pathological type was mainly LN- 鈪，

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