Analysis Of Clinical And Pathological And Immunological Characteristics Of 109 Cases Of Lupus Nephritis Patients

Objective:To search for the relationship among the pathological types, clinical manifestations and immunological characteristics in lupus nephritis (LN) patients,in order to improve the understanding of LN.Method:Retrospective study was done on 109 cases of LN patients daignozed by renal pathology from Nephrology ward and TCM ward in our hospital (patients From January 2008 to August 2014). The renal pathology were categorized according to the international society Of Nephrology and renal pathology society (ISN/RPS) classification schemes in 2003, and the LN activity index(AI), chronic index (CI), systemic lupus erythematosus disease activity index (SLEDAI), renal tubulointerstitial lesions (TIL) were scored and drawed the related conclusions by statistical methods.Results:1.The distribution of pathological types:Among 109 cases of patients,50 cases of type Ⅳ,21 cases of type Ⅴ,11 cases of type Ⅴ+Ⅳ,10 case of type Ⅲ,9 cases of type Ⅴ+Ⅲ,7 cases of type Ⅱ,1 cases of type Ⅰ.There have no significant difference in all antibodies and complements deposition in various types of LN pathology (P>0.05).2.Age and sex distribution:Among 109 cases of patients,22 cases were male (20.18%), 87 cases were female(79.82%), the ratio was 1:3.95, The age of onset is 7 to 65 years old, average 30.34±12.49.The age of onset in men is 10 to 64 years old and average age is 34.41 ±15.67. The age of onset in women is 7 to 65 years old and average age is 29.31± 11.44 years old.3.The clinical manifestations of LN:Among 109 cases of patients, the clinical manifestation which contains 81 cases of facial swelling or edema of lower limbs with or without foam in urine,49 cases with joint pain,40 cases with rash (including malar erythema or discoid),39 cases with serositis(including pleural or pericardial effusion).4. Comparison of laboratory indexes:The decreased of hemoglobin was the most significant in type Ⅳ;the 24-hour urine protein quantitation of type Ⅳ,Ⅴ,Ⅴ+Ⅳ,Ⅴ+ Ⅲ is significantly higher than that of type Ⅱ,Ⅲ (P<0.05); The urea nitrogen and blood creatinine of type Ⅲ,Ⅳ,Ⅴ+Ⅳ are significantly higher than that of other types (P<0.05,P<0.01).The rate of anti-dsDNA antibody is higher in type III and IV than other types (P<0.01)5. Analysis of LN activities index:The AI of type Ⅳ and Ⅴ+Ⅳ are significantly higher than other types (P<0.01).The CI of type IV and Ⅴ+Ⅳ are significantly higher than other types (P<0.05). The TIL of type Ⅳ and Ⅴ+Ⅳ are significantly higher than other types(P<0.01). The SLEDA of type Ⅱ,Ⅳ,Ⅴ+Ⅳ increase more significantly than others (P>0.05).Conclusion:According to retrospective analysis of single center1.type Ⅳ is the most common (45.87%).2.The young and middle aged women are prone to LN.3.There is heavier anemia in type IV.The rate of anti-dsDNA antibody is high in type Ⅲ and Ⅳ.4. Type Ⅳ,Ⅴ,Ⅴ+Ⅳ,Ⅴ+Ⅲ have more severe urine protein excretion.5. The AI, CI, TIL score of type Ⅳ,Ⅴ+Ⅳ are significantly higher than other types of LN.