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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。
Objective: To investigate the relationship between glomerular filtration rate (GFR) and pathological type and clinical indexes in patients with lupus nephritis (LN). Methods: Serum creatinine (Scr), blood urea nitrogen (BUN), serum albumin, 24 h urinary protein, complement C3, C4, anti ds DNA were detected in 39 patients with lupus nephritis. Antibody titers and body weights were measured. Patients’ ages and SLEDAI scores were also recorded. GFR was calculated using the MDRD-7 formula. Results: There were no significant differences in the Scr, BUN and GFR between different pathological types of LN (P> 0.05). There was a significant difference in the pathological types of serum albumin (P <0.05). Correlation analysis showed that there was a negative correlation between 24 h urinary protein and GFR in patients with LN (r = -0.330, P = 0.040), GFR and SLEDAI scores of LN patients, complement C3 and C4 levels, anti-dsDNA antibody titers No significant correlation was found. CONCLUSION: The results of pathological classification of LN can not replace the assessment of renal function by GFR. The quantification of 24-h urinary protein in LN patients can assess renal function to a certain extent. The SLEDAI scores, C3, C4 and anti-dsDNA antibody titers do not reflect The degree of kidney damage in patients.