李荣藻 叶任高 方敬爱 孙林 李荣藻 512026 广东省韶关市，粤北人民医院肾内科；叶任高 孙林 中山医科大学第一附属医院肾内科；方敬爱 山西医科大学第一附属医院肾内科 中华肾脏病杂志 1999 0 15 1


    关键词：狼疮肾炎；终末期肾病；狼疮活动性；存活率 期刊 zhszbzz 0 论著 fur -->


    

【摘要 】 目的 探讨狼疮肾炎(LN)患者发展至终末期肾病(ESRD)时狼疮活动情况和预后的关系。方法 分析1987～1997年资料完整的71例LN的ESRD患者临床性SLE活动和血清学SLE活动的各项指标、死亡原因，分析比较LN的ESRD患者与非LN的ESRD患者的存活率。结果 本组LN的ESRD患者在进行透析治疗前有64.8%已没有SLE临床活动表现。进行透析治疗后，SLE临床性活动渐趋静止状态，活动率从第一年56.3%下降至第十年2.8%；SLE血清学活动表现的消退，要比临床活动表现的消退缓慢；LN的ESRD透析治疗患者第2、5、10年的存活率与非LN透析患者相近，分别为79.6%、52.5%、30.5%，其死亡原因似与SLE活动无关。结论 在LN的ESRD期间，SLE活动的静止趋势与时俱增，死亡原因与SLE活动性似无明显关系，LN的ESRD替代治疗患者的预后与非LN的ESRD替代治疗患者相同。当LN发展至不可逆的ESRD时，需长期作肾脏替代治疗，无必要再应用免疫抑制治疗。

A study of the end stage of lupus nephritis about activity and prognosis

LI Rongzhao^* ,YE Renguao,FANG Jingai,et al.^* Division of Nephrology,Yuebei People's Hospital,Shaoguan,Guangdong 512026

【Abstract 】 Objective To study the relationship between the lupus active condition and prognosis on end stage renal disease(ESRD)of lupus nephritis(LN).Methods The complete clinical informations of 71 cases,from 1987 to 1997,with ESRD of LN were analysed,including clinical,serological index of lupus activity and the cause of death.The survival rate of LN ESRD was compared with that of Non-LN ESRD.Results 64.8% LN patients lost their clinical activity before receiving dialysis.A decline tendency was observed in clinical activity.The scale of lupus activity decreased from 56.3% in the first year to 2.8% in the 10th year.The regression of serological activity was slower than that of clinical manifestation.The survival rate of LN-ESRD in 2,5,10year was 79.6%,52.5% and 30.5%respectively,which was close to non-LN ESRD.The death cause of LN ESRD seemed no association with the activity of systemic lupus erythematosus.Conclusion During ESRD,the quiescent tendency of lupus activity is obvious.Lupus activity is not the death cause of LN ESRD.There is no difference in the prognosis between LN ESRD and non-LN ESRD.Therefore,it is necessary for those patients with renal failure without reversibility to get long-term dialysis,and there is also no need to use immunosuppressive treatment.

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