Correlative Study Of Pathological Type And Clinical Characteristics In Lupus Nephritis

Objective:To investigate the clinical manifestations,laboratory changes,immunological characteristics,the activities index(AI) and the chronic index(CI),tubulointerstitia(lTIL)lesions,lupus disease activity index (SLEDAI) and the relationship among them of different pathological types in lupus nephritis(LN),which had renal biopsy ,and to be convenient to further understand the nature of LN,and to improve the basis for the treatment.Method:100 LN patients were included in this study,who choosed in the first affiliated hospital of GuangXi Medical University in 2008 and had renal biopsy. Clinical data were collected from the history records,The histological classifications were categorized according to 2003 ISN/RPS classification,the lupus AI,CI,TIL lesions and SLEDAI were scored. Retrospectively analysis of general information,pathological types,clinical and immune characteristics and assessed the activities and chronic degree of different renal pathological types and then drew a conclusion by statistical analysis.Result:①87 female patients(87%), age of onset in 12 to 74 years old, with an average age of 30.23±12.57;13 male patients(13%), age of onset in 15-62 years old,with an average age of 35.92±15.84. The ratio of male and female patients is 1:6.69. The average onset age of male patients is higher than female patients', but there is no significant difference(F=2.16,P> 0.05).②The renal pathological types show: typeⅠ6%;TypeⅡ28%;typeⅢ9%;Type Ⅳ42%;typeⅤ9%;typeⅤ+Ⅳ6%.③typeⅠ,Ⅱa re mainly as latent nephritis and nephritic syndrome(100% and 92.9% respectively); typeⅢ,Ⅴare mainly as nephritic syndrome(66.7% and 66.7% respectively);typeⅣ,Ⅴ+Ⅳare mainly as nephrotic syndrome(71.4% and 66.7% respectively). Renal failure is mainly presented in typeⅣ(X2=14.47,P<0.05).④HGB of typeⅣandⅤ+Ⅳis lower than which of other histological types(F=10.93,P<0.05), and anemia is more frequent than that of other pathological types(X2=19.95,P<0.05);24hUpr of typeⅢ,Ⅳ,Ⅴ,Ⅴ+Ⅳis significantly higher than which of typeⅠ,Ⅱ(F=2.89,P<0.05);BUN of typeⅣa ndⅤ+Ⅳis significantly higher than which of other types(F=3.27,P<0.05); Scr of typeⅢ,Ⅳ,Ⅴ,Ⅴ+Ⅳis significantly higher than which of typeⅠ,Ⅱ(F=2.78,P<0.05).⑤There are no significant differences among the positive rates of autoantibodies of various pathological types(P> 0.05).⑥AI, CI, TIL scores of typeⅣ,Ⅴ+Ⅳare the highest and the difference is significant compared with other types(F=14.04,P<0.05;F=17.97,P<0.05;F=17.3,P<0.05);SLEDAI scores among the different groups are no significant differences(F=2.73,P>0.05).⑦Grade 3 of TIL lesions is in typeⅣonly;the TIL lesions of typeⅣ,Ⅴ+Ⅳare the most seriou(sX2=37.65,P<0.05);The higher TIL lesions are,the higher Scr level and BUN level ar(eF=4.19,p<0.05;F=7.44,P<0.05).⑧HBP is mainly presented in the typeⅣ(X2=11.61,P<0.05);other clinical manifestations of various pathological types are no significant differences(P> 0.05).Conclusion:1,typeⅣis the most common pathological type(42%). 2,typeⅠ,Ⅱare mainly as latent nephritis and nephritic syndrome; typeⅢ,Ⅴare mainly as nephritic syndrome;typeⅣ,Ⅴ+Ⅳare mainly as nephrotic syndrome. typeⅣis more prone to have renal insufficiency. 3,HBP is more common in typeⅣ;other clinical manifestations have no significant correlations with pathological types. 4,typeⅣ,Ⅴ+Ⅳhave the highest incidences of anemia and the most severe anemia and the highest amounts of BUN. 5,AI,CI,TIL scores of typeⅣ,Ⅴ+Ⅳare the highest. 6,the level of BUN and Scr have a positive correlation with the degree of TIL lesions.