J Rheumatol:增生性狼疮肾炎中新月体对肾脏结局的意义

2018-03-15 xiangting MedSci原创

新月体>25%的增生性狼疮肾炎的短期和长期肾脏预后更差。细胞和纤维细胞新月体比例是肾脏存活率差的独立危险因素。

这项研究旨在确定新月体与肾脏结局之间的关联,以及对治疗方案选择的影响。

将231例活检证实的增生性狼疮肾炎(PLN)患者分为4组:非新月体组(NC组)59例; 仅有节段性新月体59例,为节段性新月体组(SC); 周围新月体根据新月体比例分为2组(C1有64例≤25%,C2有49例> 25%)。比较了患者的基线实验室检查,组织病理学表现和预后。

NC组、SC组、C1组和C2组的缓解率分别为92.1%、85.4%、95.0%和76.1%。C2组患者达到完全缓解的患者较其他三组少。对于通过血清肌酐(SCr)加倍或终末期肾病(ESRD)评估的长期结局,C2组肾存活率最低(p = 0.003)。单独在Cox比例风险回归模型中包括临床和病理变量,多变量分析显示以下指标是SCr加倍或ESRD的独立危险因素:基线SCr(每增加1mg/dl:HR = 1.834,95%CI1.465- 2.296; p <0.001),血红蛋白(每增加1g /l:HR = 0.970,95%CI 0.947-0.992; p = 0.009),细胞新月体的比例(每增加1%:HR = 1.040,95%CI 1.015-1.066; p = 0.002),纤维细胞新月体(每增加1%:HR = 1.085,95%CI 1.013-1.163; p = 0.020)和重度肾小管萎缩(HR = 5.348,95%CI 1.278-22.373; p = 0.022)。

新月体>25%的增生性狼疮肾炎的短期和长期肾脏预后更差。细胞和纤维细胞新月体比例是肾脏存活率差的独立危险因素。

原始出处:
Fanghao Cai, Fei Han, Hongya Wang, et al. The Crescentic Implication of Renal Outcomes in Proliferative Lupus Nephritis. J Rheumatol. February 2018.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1757305, encodeId=8b501e57305e0, content=<a href='/topic/show?id=2f354231613' target=_blank style='color:#2F92EE;'>#增生性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42316, encryptionId=2f354231613, topicName=增生性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f7c37300907, createdName=ms7514935887898259, createdTime=Sat Jun 16 08:39:00 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332947, encodeId=f289133294e0e, content=<a href='/topic/show?id=d17c68153ab' target=_blank style='color:#2F92EE;'>#狼疮肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68153, encryptionId=d17c68153ab, topicName=狼疮肾炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d4902500082, createdName=1249883fm12暂无昵称, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1387252, encodeId=709c138e2525b, content=<a href='/topic/show?id=8a3a6814425' target=_blank style='color:#2F92EE;'>#狼疮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68144, encryptionId=8a3a6814425, topicName=狼疮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a6e2500005, createdName=sunrural_42825357, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428686, encodeId=d731142868613, content=<a href='/topic/show?id=71b182e3237' target=_blank style='color:#2F92EE;'>#肾脏结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82732, encryptionId=71b182e3237, topicName=肾脏结局)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76614125796, createdName=szhvet, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1532250, encodeId=5ef315322500f, content=<a href='/topic/show?id=10b5825e4aa' target=_blank style='color:#2F92EE;'>#肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82574, encryptionId=10b5825e4aa, topicName=肾炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84df12331144, createdName=villahu, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1757305, encodeId=8b501e57305e0, content=<a href='/topic/show?id=2f354231613' target=_blank style='color:#2F92EE;'>#增生性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42316, encryptionId=2f354231613, topicName=增生性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f7c37300907, createdName=ms7514935887898259, createdTime=Sat Jun 16 08:39:00 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332947, encodeId=f289133294e0e, content=<a href='/topic/show?id=d17c68153ab' target=_blank style='color:#2F92EE;'>#狼疮肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68153, encryptionId=d17c68153ab, topicName=狼疮肾炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d4902500082, createdName=1249883fm12暂无昵称, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1387252, encodeId=709c138e2525b, content=<a href='/topic/show?id=8a3a6814425' target=_blank style='color:#2F92EE;'>#狼疮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68144, encryptionId=8a3a6814425, topicName=狼疮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a6e2500005, createdName=sunrural_42825357, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428686, encodeId=d731142868613, content=<a href='/topic/show?id=71b182e3237' target=_blank style='color:#2F92EE;'>#肾脏结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82732, encryptionId=71b182e3237, topicName=肾脏结局)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76614125796, createdName=szhvet, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1532250, encodeId=5ef315322500f, content=<a href='/topic/show?id=10b5825e4aa' target=_blank style='color:#2F92EE;'>#肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82574, encryptionId=10b5825e4aa, topicName=肾炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84df12331144, createdName=villahu, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1757305, encodeId=8b501e57305e0, content=<a href='/topic/show?id=2f354231613' target=_blank style='color:#2F92EE;'>#增生性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42316, encryptionId=2f354231613, topicName=增生性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f7c37300907, createdName=ms7514935887898259, createdTime=Sat Jun 16 08:39:00 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332947, encodeId=f289133294e0e, content=<a href='/topic/show?id=d17c68153ab' target=_blank style='color:#2F92EE;'>#狼疮肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68153, encryptionId=d17c68153ab, topicName=狼疮肾炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d4902500082, createdName=1249883fm12暂无昵称, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1387252, encodeId=709c138e2525b, content=<a href='/topic/show?id=8a3a6814425' target=_blank style='color:#2F92EE;'>#狼疮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68144, encryptionId=8a3a6814425, topicName=狼疮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a6e2500005, createdName=sunrural_42825357, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428686, encodeId=d731142868613, content=<a href='/topic/show?id=71b182e3237' target=_blank style='color:#2F92EE;'>#肾脏结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82732, encryptionId=71b182e3237, topicName=肾脏结局)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76614125796, createdName=szhvet, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1532250, encodeId=5ef315322500f, content=<a href='/topic/show?id=10b5825e4aa' target=_blank style='color:#2F92EE;'>#肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82574, encryptionId=10b5825e4aa, topicName=肾炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84df12331144, createdName=villahu, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1757305, encodeId=8b501e57305e0, content=<a href='/topic/show?id=2f354231613' target=_blank style='color:#2F92EE;'>#增生性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42316, encryptionId=2f354231613, topicName=增生性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f7c37300907, createdName=ms7514935887898259, createdTime=Sat Jun 16 08:39:00 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332947, encodeId=f289133294e0e, content=<a href='/topic/show?id=d17c68153ab' target=_blank style='color:#2F92EE;'>#狼疮肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68153, encryptionId=d17c68153ab, topicName=狼疮肾炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d4902500082, createdName=1249883fm12暂无昵称, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1387252, encodeId=709c138e2525b, content=<a href='/topic/show?id=8a3a6814425' target=_blank style='color:#2F92EE;'>#狼疮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68144, encryptionId=8a3a6814425, topicName=狼疮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a6e2500005, createdName=sunrural_42825357, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428686, encodeId=d731142868613, content=<a href='/topic/show?id=71b182e3237' target=_blank style='color:#2F92EE;'>#肾脏结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82732, encryptionId=71b182e3237, topicName=肾脏结局)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76614125796, createdName=szhvet, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1532250, encodeId=5ef315322500f, content=<a href='/topic/show?id=10b5825e4aa' target=_blank style='color:#2F92EE;'>#肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82574, encryptionId=10b5825e4aa, topicName=肾炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84df12331144, createdName=villahu, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1757305, encodeId=8b501e57305e0, content=<a href='/topic/show?id=2f354231613' target=_blank style='color:#2F92EE;'>#增生性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42316, encryptionId=2f354231613, topicName=增生性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f7c37300907, createdName=ms7514935887898259, createdTime=Sat Jun 16 08:39:00 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332947, encodeId=f289133294e0e, content=<a href='/topic/show?id=d17c68153ab' target=_blank style='color:#2F92EE;'>#狼疮肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68153, encryptionId=d17c68153ab, topicName=狼疮肾炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d4902500082, createdName=1249883fm12暂无昵称, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1387252, encodeId=709c138e2525b, content=<a href='/topic/show?id=8a3a6814425' target=_blank style='color:#2F92EE;'>#狼疮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68144, encryptionId=8a3a6814425, topicName=狼疮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a6e2500005, createdName=sunrural_42825357, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428686, encodeId=d731142868613, content=<a href='/topic/show?id=71b182e3237' target=_blank style='color:#2F92EE;'>#肾脏结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82732, encryptionId=71b182e3237, topicName=肾脏结局)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76614125796, createdName=szhvet, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1532250, encodeId=5ef315322500f, content=<a href='/topic/show?id=10b5825e4aa' target=_blank style='color:#2F92EE;'>#肾炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82574, encryptionId=10b5825e4aa, topicName=肾炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84df12331144, createdName=villahu, createdTime=Sat Mar 17 06:39:00 CST 2018, time=2018-03-17, status=1, ipAttribution=)]
    2018-03-17 villahu