| 1、Background and ObjectiveBackground: Systemic lupus erythematosus(SLE) is a more common autoimmune disease in clinical practice. The characteristics of SLE are its complex in clinical manifestations and multiple organ damage, among which lupus nephritis(LN) is the most common. SLE has obvious tendency of gender, and some studies have shown that the sex ratio is 1:7-1:9. Due to the lower prevalence and fewer cases in male patients, the related documents and reports at home and abroad are relatively rare. Some literatures showed that male patients with SLE were more atypical in clinical manifestations and had more serious viscera damage compared with female patients, therefore it is significant to study the clinical and pathological characteristics of male patients with SLE in improving its diagnosis rate, treatment and evaluating prognosis.Objective: Aimed to increase the understanding of SLE in male patients, we analyzed the clinical characteristics of 68 cases retrospectively, compared with female patients in the same period, and analyzed the relationship between the pathologic types of 31 male patients with LN who underwent renal biopsy, their clinical manifestations and laboratory indexes.2、MethodIn order to observe the clinical characteristics of male patients with SLE, We retrospectively analyzed the clinical indexes of 648 cases with SLE received by the second hospital of Jilin University from October 2005 to October 2015, among which 68 cases were male patients and other 580 cases were female. At the same time, we analyzed the relationship between the pathologic types of 31 male patients with LN who underwent renal biopsy and the clinical indicators. Clinical data was from medical records, including gender, age, clinical symptoms, common laboratory result, renal biopsy pathology and so on.Qualitative data was expressed as the number of cases of clinical and laboratory(percentage), and the quantitative data was expressed as a mean ± standard deviation( X ±S). The statistical data was analyzed through t test and chi-square test.3、Result1) Among 648 cases of SLE patients including 68 cases of male patients and580 cases of female, the proportion of men and women is 1:8.5. The onset age of men was between 13 and 87, and the average age was 38.79 ±17.91. The onset age of women was between 5 and 92, and the average age was 37.90 ± 14.58. The average onset age had no significant difference with gender. 2) Among the extrarenal manifestations, the incidence of allergies, arthritis in male was lower than those in female(P<0.05). And male patients had a similar rate of oral ulcers, skin damage,hair loss and the serositis aspects to female. 3) Male and female patients had no significant difference on blood system, pulmonary hypertension, pulmonary interstitial change. 4) Male had the higher incidence of renal damage than female(P<0.05). 5) On the immunological indexes, male patients’ incidence of anti-ds DNA was lower than those of female(P<0.05), but the positive rate of ANA,anti-Sm,anti-U1 RNP, anti-SSA, anti-SSB and the variety of immune globulin,C3, C4 were all similar to female. 6)The proportions of different pathological types in male patients with LN showed type Ⅱ(3.23%), type Ⅲ(16.12%)( Among which type Ⅲ+Ⅴwas 3.23%), type Ⅳ(58.06%)(Among which type Ⅳ+Ⅴwas25.81%) and type Ⅴ(22.58%). Male and female patients’ structure of various pathological types was similar. The type Ⅳ had the highest incidence rate. 7) The extrarenal manifestations of different pathological types in male patients with LN:The incidence rate of skin damage and serositis apparently were higher than light allergies and oral ulcer(P<0.05). Light allergic was restricted to type Ⅳ and typeⅤ. 8) The clinical manifestations of renal damage of different pathological types in male patients with LN: The occult nephritis type was the most rare clinical manifestations of renal damage(P<0.05), and the renal insufficiency type accounted for 58.06% of the total, which was significantly higher in type Ⅳ than type Ⅲ and typeⅤ(P<0.05). 9)The incidence of pulmonary hypertension and interstitial change in the male patients with LN were 9.68% and 12.90% respectively, and their occurrence had no significant correlation with the pathological types. 10) The laboratory result of different pathological types in male patients with LN: Male patients with LN whose glomeruler filtration rate reducing accounted for about58.06%,and the incidence was significantly higher in type Ⅳ than type Ⅲ and type Ⅴ(P<0.05). Hypoalbuminemia had high incidence rate in each type, and among them the incidence of type Ⅳ was 100%.Anemia was more common in typeⅣ than type Ⅴ(P<0.05).4、Conclusion1) The incidence of male patients with SLE was lower than that of female obviously, but it had no difference on the onset age. 2) Compared with female patients, male patients with light allergies and arthritis were relatively less, and the renal damage was more serious. 3) The positive rate of ds-DNA in male patients was lower than that in female. 4) The pathological distribution of male patients with LN was similar to female, among which type IV was the most common type. And anemia was more common in type IV compared with type Ⅴ. 5) The incidence of skin damage and serositis apparent was higher than light allergies and oral ulcer in male patients with LN among all the extrarenal manifestations. |
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