摘要
目的探讨狼疮性肾炎(LN)患者面部蝶形/盘状红斑和肾脏损害的关系。方法将2013至2018年在西南医院住院的305例LN患者按有无伴发面部蝶形/盘状红斑分为皮疹组和无皮疹组,评估两组患者临床特点的差异。结果48.5%的LN患者出现过皮疹,未成年发病患者皮疹发生率(69.0%)高于成年发病(45.6%)和迟发性患者(23.8%),肾脏病理为“膜性+增殖性”患者皮疹发生率(59.4%)高于非增殖性(43.4%)和增殖性(42.5%)患者(P<0.05)。皮疹组的发病年龄更小、病程更长,并发关节痛、发热、脱发的比例更高,而出现肾功能不全的比例更低(P<0.05)。Logistic回归分析显示皮疹组出现肾功能不全的风险低于无皮疹组[OR(95%CI)=0.430(0.256~0.721),P<0.05]。结论不伴皮疹的LN患者更易发生肾功能不全,应注意随访肾功能以利于早期发现肾损害并及时治疗。
Objective To investigate the relationship between malar/discoid rash and renal damage in lupus nephritis(LN)patients.Methods 305 LN patients who were admitted to Southwest Hospital from 2013 to 2018 were divided into two groups according to with or without malar/discoid rash.Clinical characteristics of LN patients from these two groups were compared.Results 48.5%of LN patients had rash.Childhood-onset patients(69.0%)were more likely to had rash than adult-onset(45.6%)and late-onset patients(23.8%).Patients whose pathological types were membranous and proliferative were more likely to had rash(59.4%)than whose pathological types were non-proliferative(43.4%)and proliferative(42.5%)(P<0.05).The patients with rash had younger disease-onset,longer disease course,and higher incidence of arthalgia,fever,and alopecia,but lower frequency of renal insufficiency(P<0.05).Patients with rash had a lower risk of developing renal dysfunction than those without[OR(95%CI)=0.430(0.256-0.721),P<0.05].Conclusions LN patients without rash have a higher proportion of renal dysfunction.Physicians should pay attention to these patients for early detection of renal damage and timely treatment。
作者
吴奇俊
张东梅
宋志强
WU Qi-jun;ZHANG Dong-mei;SONG Zhi-qiang(Department of Dermatology,Southwest Hospital,Army Medical University,Chongqing 400038,China)
出处
《中华临床免疫和变态反应杂志》
2020年第5期457-460,共4页
Chinese Journal of Allergy & Clinical Immunology
基金
国家自然科学基金(81673068)
陆军军医大学第一附属医院创新团队培养计划(SWH2018TD-02)。