带有新月的狼性炎:临床病理学概况和不良结果的预测因素
Asif Sadiq Wani1, Anupma Kaul1, Zafirah Zahir2
1Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
概括
狼性炎的结果取决于新月的百分比. 与50%以上的新月相比,较少的新月 (≤50%) 显示出更好的缓解和较低的慢性病风险,这表明在严重的情况下需要密集免疫抑制.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 病理学 病理学 病理学
背景情况:
- 狼性炎影响10-40%的系统性红斑狼患者.
- >50%的质细胞半月体预测预后不佳,但半月体较少的结果不太了解.
- 这项研究调查了基于狼性炎的新月百分比的临床病理学概况和治疗结果.
研究的目的:
- 为了比较狼性炎的临床病理学概况,使用不同的新月百分比.
- 为了评估治疗结果,免疫抑制类型,以及不良结果的预测因素.
- 了解新月负担对疾病进展和缓解率的影响.
主要方法:
- 在14年内进行的回顾性单中心队列研究.
- 分析了8515个本地脏活检,确定了457例狼性炎,110例新月.
- 根据新月的百分比对患者进行分类:Cr1 (≤25%),Cr2 (25-50%),Cr3 (>50%).
主要成果:
- 在Cr1 (33.3%/17.6%) 和Cr2 (24.1%/10.3%) 与Cr3 (13.0%/3.3%) 相比,观察到更高的缓解率 (CR/PR).
- 与Cr1和Cr2相比,Cr3的慢性病率 (43.3%) 和末期病率 (10.0%) 显著高于Cr1.
- 预测不良结果的预测因素包括高血清肌素,低EGFR,RPGN呈现,淋巴细胞硬化,管状缩和>50%的新月.
结论:
- 狼性炎具有较高的新月比例呈现出侵略性,进展迅速,治疗反应不佳.
- 半月的百分比是影响狼性炎预后和治疗疗效的关键因素.
- 在狼性炎病例中,有显著的新月形成 (>50%),需要强化免疫抑制.
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