系统性红斑狼的尿路异常并不总是表明狼性炎:一个横截面队列研究
Linnea Karlsson1, Agneta Zickert1,2, Elisabet Svenungsson1,2
1Department of Medicine, Division of Rheumatology, Karolinska Institutet, Solna, Sweden.
Clinical rheumatology
|July 13, 2023
概括
活检对于在SLE患者中诊断狼性炎 (LN) 和其他病至关重要. 即使蛋白尿低,也可能存在严重的LN,这突显了早期活检和治疗的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 类风湿病学 类风湿病学
- 病理学 病理学 病理学
背景情况:
- 脏活检是诊断炎症性脏疾病的黄金标准,如狼性炎 (LN).
- 系统性红斑狼 (SLE) 患者经常接受脏活检,以评估脏参与.
- 在SLE患者中调查非LN组织病理学发现对于准确的诊断和治疗至关重要.
研究的目的:
- 为了调查SLE患者第一次脏活检中的组织病理学发现.
- 为了确定非LN基因病理发现的发生和类型.
- 在已建立的SLE分类系统中分析脏标准的满足情况.
主要方法:
- 对139名SLE患者进行首次脏活检 (1995-2021) 的回顾性分析.
- 根据组织学,患者被分为LN和非LN组.
- 临床和实验室特征在LN和非LN组之间进行了比较.
主要成果:
- 88.5%的患者 (123/139) 的发现与LN一致;11.5% (16/139) 的发现与非LN一致.
- 非LN患者在SLE诊断时年龄较大,疾病持续时间较长.
- 低级蛋白尿 (<0.5g/24h) 在20%的严重LN (III/IV类) 患者中观察到.
结论:
- 活检对于排除SLE患者的非LN病理至关重要.
- 低级蛋白尿并不排除需要免疫抑制的活跃狼性炎.
- 早期脏活检对于及时诊断和改善狼性炎的结果至关重要.
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