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【摘要 】 目的 调查狼疮性肾炎(LN)患者的长期存活率并分析影响存活率的预后因素。方法 对1983年12月至1996年12月住院的588例LN病人进行回顾性分析，采用非参数乘积限估计法分析生存率，采用COX模型分析预后因素。结果 LN病人1、5、10、13年存活率分别为88.0%、74.2%、59.1%及53.4%。影响生存的预后因素有血清肌酐≥120 μmol/L，尿细胞管型，系统性红斑狼疮活动指数(SLEDAI)≥20分，年龄≤15岁，合并感染及肾脏病理WHO分型Ⅳ型，其中，血清肌酐升高及狼疮活动指数≥20分是独立的预后影响因素。激素加环磷酰胺治疗能提高存活率。结论 肾脏受损及狼疮活动程度是影响LN预后的重要因素，积极的免疫抑制治疗有利于改善预后。
Survival probability and predictors of death in patients with lupus nephritis Lu Caisheng, Ye Rengao, Sun Lin, et al. Institute of Kidney Diseases, Sun Yatsen University of Medical Sciences, Guangzhou 510080
【 Abstract 】 Objective To investigate the survival probability and predictors of death in patients with lupus nephritis (LN). Methods 588 patients who were admitted into and diagnosed as LN at the First 1st Affiliated Hospital of Sun Yat-sen University of Medical Sciences from Dec. 1983 to Dec. 1996 were studied. Survival probabilities were studied with Kaplan-Meier method and predictors of death were analyzed with the Cox proportional hazards model. Results The overall survival probabilities at 1, 5, 10 and 13 years after diagnosis were 88.0%, 74.2%, 59.1% and 53.4% respectively. Serum creatinine ≥ 120 μ mol/L, SLE disease activity index (SLEDAI) ≥ 20 scores, age ≤ 15 years, infection and World Health Organization histology class IV in the biopsied material were predictive factors for mortality, among which increased serum creatinine and SLEDAI ≥ 20 scores were independent factors significantly associated with low survival probability. Prednisone plus cyclophosphamide could improve survival. Conclusion Renal abnormalities and high lupus activity index are the most important survival predictors in LN patients. Active immunosuppresive therapy can improve the prognosis of LN nephritis.
【 Key words 】 Nephritis, lupus Survival rate Risk factors
狼疮性肾炎(LN)是系统性红斑狼疮(SLE)最重要的临床表现 ......
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