摘要
目的：探讨未成年起病女性狼疮性肾炎（ Ｌ Ｎ） 的临床和预后。 方法：回顾性分析３１ 例未成年起病女性 Ｌ Ｎ 的临床、病理和预后，并与同期４５９ 例育龄妇女及６９ 例男性患者比较。 结果：①在４９５ 例女性患者中，未成年起病（１４ 岁以前） 患者３１ 例，占女性病例的６２６ ％ ，同期６９ 例男性患者中有４ 例１４ 岁前起病，未成年起病男女比例为１∶７７５ ；②未成年女性患者中有６７７４ ％ 以肾脏病变起病，而育龄女性半数以肾外表现起病，且从出现肾外病变到发生肾脏病变间的间期较长（ 育龄女性平均为２０２０ 个月，未成年女性为１０３８ 个月） ；③未成年女性Ⅳ型 Ｌ Ｎ 占７４１９ ％ ，其蛋白尿、血尿及肾功能损害也较重；此外还较常累及心脏、中枢神经及血液系统；④未成年女性 Ｌ Ｎ 预后差，随访５ 年后肾功能稳定率为３６５７ ％ ，同期育龄妇女有８２６８ ％ 保持肾功能稳定；⑤未成年女性 Ｌ Ｎ 的上述表现与育龄女性有较大差别，而与男性较为接近。 结论：未成年起病的女性 Ｌ Ｎ 较为少见，但其大多为弥漫增生型，病变重、预后差，而与男性 Ｌ Ｎ 较为相似。
OBJECTIVE To study the clinical features and prognosis of female patients with childhood onset lupus nephritis. METHODOLOGY The clinical features and prognosis in 31 female patients with childhood onset lupus nephritis were analyzed retrospectively,and compared with those in 459 female patients with late onset lupus nephritis and those in 69 male patients. RESULTS (1)In all the 564 lupus nephritis patients,there were 31 females and 4 males whose onset of lupus was before the age of 14.The ratio of male to female was 1∶7 75.(2)In the group of early onset patients,renal involvement was found in 67 7% as one of the onset manifestations.Higher rates of heart involvement and central nervous system involvment were found in the early onset lupus nephritis patients as compared to those in late onset female patients(54 84% vs. 26 36%,and 22 58% vs .8 49%).(3)Early onset female patients had more severe renal disease:74 19% of them suffered form diffuse proliferative nephritis,and had significantly higher mean values of proteinuria and hematuria than late onset patients.(4)The early age of onset is related with a worse prognosis at 5 years,the probability of no renal failure was 36 57% in childhood onset female patients,while it was 82 68% in late onset female patients. CONCLUSION Childhood onset female lupus nephritis is associated with severe renal damage and frequent cardiac and central nervous system involvment.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1999年第4期319-322,337,共5页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
狼疮性肾炎
未成年女性
预后
诊断
childhood systemic lupus erythromatosis
lupus nephritis
prognosis
