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为提高对狼疮性肾炎弥漫增殖型（ＬＮⅣ）的认识，该文对４８例ＬＮⅣ型的临床、病理、治疗及预后进行探讨。结果示肾脏多表现为肾病综合征或肾炎综合征、急性肾衰；免疫荧光几乎呈“满堂亮”；电镜下系膜区均有电子致密物沉积，部分伴内皮下或上皮下大块电子致密物沉积。提示ＬＮⅣ型临床活动常与病理急性活动病变相伴行，病理急性活动指数的升高不能预示不良转归的发生，激素加环磷酰胺间歇冲击治疗可提高近期与远期疗效，改善预后。
In order to improve the understanding of diffuse proliferative type (LN Ⅳ) of lupus nephritis, 48 cases of LN Ⅳ type of clinical, pathological, treatment and prognosis were discussed. The results showed that the kidneys showed mostly nephrotic syndrome or nephritic syndrome, acute renal failure; immunofluorescence was almost “full house bright” electron microscopy under electron-dense deposition of mesangial area, some with subcutaneous or subepithelial bulk electron dense material Deposition. It is suggested that the clinical activities of LN Ⅳ are often associated with the pathological acute lesions. The increase of pathological acute activity index can not predict the occurrence of adverse outcomes. The treatment with intermittent shock plus cyclophosphamide can improve the short-term and long-term effects and improve the prognosis.