Clinical And Pathological Analysis Of Lupus Nephritis With Different Complement Activation Pathways

Objective: This study will observe the clinical and pathological manifestations of lupus nephritis without complement activation pathway.Methods: The clinical and pathological data of 182 patients with lupus nephritis who first visited The First Affiliated Hospital of Wannan Medical College from 2012 to 2021 were collected.According to the level of complement C3 and C4,it is divided into two groups.The complement system is mainly activated by the classical pathway(CP)CP group(both serum C3 and C4 are reduced),and the complement system is only activated by the alternative pathway(AP)AP group(serum C3 is reduced and C4 is normal).The measurement data conforming to the normal distribution is expressed as the mean±standard deviation,and the difference analysis is carried out using t test.The measurement data of non-normal distribution is expressed by the median(P25,P75),and the difference analysis is carried out using the rank sum test.The counting data were expressed in number of cases and percentage,and analyzed by chi-square test.Compare the clinical and pathological differences between CP group and AP group.Results: 1.There were 115 people in CP group and 67 people in AP group;The average age of CP group was 36.01 ± 13.26 years old,and that of AP group was 38.42 ± 13.07 years old.2.The incidence of facial erythema and arthritis in CP group was higher than that in AP group(P<0.05).3.The levels of blood C3,C4,white blood cells and hemoglobin in CP group were lower than those in AP group(P<0.05),while Ig G,Ig E and Ig M were higher than those in AP group(P<0.05).4.The positive rate of anti-ds DNA antibody in CP group was higher than that in AP group(P<0.05).5.The24-hour urine protein content in CP group was higher than that in AP group(P<0.05).6.The systemic lupus erythematosus disease activity index(SLEDAI)in CP group was significantly higher than that in AP group(P<0.01).7.In CP group,the most common pathological type was V+IV in 29 cases(25.22%),followed by IV in 25 cases(21.74%);In AP group,19 cases(28.36%)of type V+IV were the most common,followed by 15cases(22.39%)of type V.There was no statistical difference in the distribution of pathological types between the two groups(P>0.05);The pathological activity index(AI)of CP group was higher than that of AP group(P<0.05).Conclusion: In this study,the complement activation mode of lupus nephritis is mainly through the classical pathway,and its disease activity degree and pathological activity index are higher than those of lupus nephritis activated only through the bypass pathway.