课件：狼疮肾炎的研究和治疗进展.ppt

ISN/RPS（2003年） I Minimal mesangial lupus nephritis II Mesangial proliferative lupus nephritis III Focal lupus nephritis (active or sclerotic lesions) IV Diffuse segmental (IV-S) or global (IV-G) lupus nephritis V Membranous lupus nephritis VI Advanced sclerosing glomerulonephritis Weening et al. J Am Soc Nephrol 2004;15:241-250 IV-G vs IV-S IV-S IV-G P value Number of patients 20 152 Hemoglobin (mean±SD) (g/L) 104.6±21.76 92.76±21.81 0.024 Urine protein (g/24 hours) 3.215,2-12 5.35,3-21 0.003 Serum creatinine (mean±SD) (mg/dL) 1.0±0.27 2.07±2.05 0.021 Creatinine clearance rate (mean±SD) (ml/min) 81.29±19.74 56.12±34.15 0.002 Number of positive ANA (%) 20(100%) 100(100%) 1.0 Number of anti-cardiolipin antibody (%) 5/15(33.3%) 8/98(8.2%) 0.014 C3 (mean±SD) (g/L) 0.46±0.19 0.38±0.16 0.045 ANCA 4/20(20%) 7/152(4.6%) 0.008 Fibrinoid necrosis 5/20(25%) 7/152(4.6%) 0.006 AI score(mean±SD) 8.75±2.73 10.93±3.36 0.006 Endocapillary hypercellualrity(mean±SD) 2.35±0.59 2.92±0.34 0.001 Interstitial inflammation(mean±SD) 1.05±0.22 1.51±0.78 0.01 Scr doubling at 5-year follow up 1/19 29/152 0.149 Yu F, et al. Lupus In press TMA in LN Yu F, et al. Nephrol Dial Transplant 2009 Aug 23, Epub LN+TTP-HUS LN-IV-G P value No of patients 7 55 HGB (g/L) 75.6±22.4 95.6±21.6 0.022 Thrombocytopenia 7(100%) 8(14.5%) 0.001 PLT(x109/L) 64.7±23.0 161.9±72.2 0.001 AKI (%) 6(85.8) 6(10.9) 0.001 AP (%) 1(14.3) 9(16.4) 1.0 SLEDAI 21.4±7.1 17.5±5.2 0.087 ADAMTS-13 activity 40.7±7.34% 81%±13%（n） 0.001 IgG ADAMTS-13 Ab 6/7 0/50 (n) AECA 6/7 0/50 (n) AI score 11.7±3.1 10.9±2.8 0.494 CI score 4.86±2.54 2.71±1.76 0.005 Yu et al. Kidney Int 2009; 76:307-317 CrGN Non-CrGN (IV) P value No. of patients 33 119 AKI (%) 33(100) 32(26.9) 0.001 Hemoglobin (g/L) 84.61±19.46 95.03±21.97 0.015 ANCA 11(30.3%) 3(2.5%) 0.001 AI score 13.48±3.09 10.22±3.09 0.001 CI score 4.85±2.17 2.86±1.77 0.001 IF-IgA 1.52±1.06 1.95±0.87 0.017 IF-IgM 1.27±0.98 1.66±0.95 0.039 IF-C1q 1.76±0.97 2.2±0.83 0.0