| Objectives:To investigate the clinical and pathological features of 85 patients with lupus nephritis(LN)and provide a theoretical basis for clinical diagnosis and treatment of lupus nephritis.Methods:From January 2012 to December 2017,the pathological data and clinical and laboratory data of 85 patients diagnosed with lupus nephritis in clinical and confirmed renal lupus nephritis by renal biopsy in the Department of Nephrology,Yan'an Hospital Affiliated to Kunming Medical University were retrospectively analyzed to clarify the clinical and pathological features of lupus nephritis.Clinical and pathological data were analyzed using SPSS Statistics 21.0 software.Results:1.General information:The patients were from various cities in Yunnan Province,with Kunming City(36 cases)being the largest,followed by Qujing City(16 cases).The ratio of women to men was:8.44:1.The number of patients aged 20-50 years was more(76.5%).2.Distribution of pathological types:Patients with pathological type ?+? have the highest proportion(35.3%),following by type ?(27.1%)and type ?++?(18.8%),and type ? accounted for a low percentage(4.7%).Patients of type I and VI are not included in this study.3.Clinical manifestations:3.The most common clinical symptoms are hypertension in 54 patients(63.5%),following by anemia in 44 patients(51.8%).Neuropathy in 2 cases(2.4%)are least common.The incidence of photoallergy in patients with pathological type IV+V is higher than those in other pathological types(P<0.05).4.Laboratory examination:All patients with LN had proteinuria,and the urine protein was(3.726 ± 2.585)g/24h.The lower serum albumin(25.589 ± 7.879)g/L was consistent with a large amount of proteinuria.Urinary red blood cells(22.3 ±78.1)/ul were significantly higher than normal.The high positive rate of ANA(88.2%).DS-DNA(10 ± 40)and ESR(25 ± 35)mm/h were higher than normal.Complement C3(0.41 ± 0.315)g/L and complement C4(0.08 ± 0.09)g/L decreased.SLEDAI scores(16.882±4.681)were significantly higher than 9 points in all pathological types.In type IV patients,platelet levels were lower,urine red blood cell levels and AI values were higher,?+?patients had higher levels of serum creatinine,urea nitrogen,urine red blood cells,and AI values,but serum albumin levels were lower.Conclusions:1.In this study,patients with pathological type IV+V have the highest proportion(35.3%).Most patients are from Kunming City,followed by Qujing City.2.The same pathological type of lupus nephritis has different clinical manifestations,and the same clinical manifestations also exist in different pathological types.There is no one-to-one correspondence between clinical data and pathological types.Therefore,renal biopsy is still an irreplaceable diagnostic method.Should be further promoted in patients with SLE,LN renal biopsy in the early stages.3.There is a certain correlation between clinical data and pathological types of lupus nephritis.Patients with pathological type ?+? had a high incidence of photosensitivity,with high levels of serum creatinine,urea nitrogen,urine red blood cells,and AI values,and low levels of serum albumin.Patients with type ? have lower platelet levels,higher levels of urine red blood cells and higher AI values.Therefore,for patients with lupus nephritis who cannot undergo renal biopsy or are unwilling to undergo a renal biopsy,the pathological type can be predicted based on clinical data and combined with clinical experience to give early treatment.4.The complexity of the pathogenesis of SLE and LN,and the diversity of pathological types and clinical manifestations should emphasize comprehensive treatment in the course of diagnosis and treatment to improve the patient's healing power and reduce the chance of entering end-stage renal disease. |
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