Clin Exp Rheumatol:狼疮性肾炎重复活检肾间质损伤加重的相关因素

2019-06-30 xiangting MedSci原创

使用羟氯喹与肾小管间质损伤加重的风险降低相关。

狼疮性肾炎(LN)的肾小管间质损伤是肾脏预后的重要预测因子。这里调查了与LN患者肾小管间质损伤加重相关的因素。

查找1997年至2017年在三级转诊医院因治疗失败进行重复肾活检的LN患者。收集临床病理学和实验室检查数据。肾小管间质损伤加重(肾小管萎缩和/或间质纤维化)定义为严重程度从无到轻度到中度到重度的进展。使用logistic回归分析评估与肾小管间质损伤加重相关的因素。

共纳入52名LN患者进行分析。在19名患者(36.5%)中观察到二次活检肾小管间质损伤加重。在多因素logistic回归分析中,使用羟氯喹(调整OR 0.215,95%CI 0.049-0.941,p=0.041)与肾小管间质损伤加重负相关。初次活检时系统性红斑狼疮疾病活动指数(SLEDAI)肾脏评分更高与肾小管间质损伤加重相关(调整OR 1.331,95%CI 1.083-1.636,p=0.007)。关于使用HCQ,HCQ治疗时间(调整OR 0.974,95%CI 0.951-0.998,p=0.036)和HCQ累积剂量(调整OR 0.485,95%CI 0.262-0.896 ,p=0.020)均与肾小管间质损伤加重呈负相关。

使用羟氯喹与肾小管间质损伤加重的风险降低相关,并且初次肾活检时SLEDAI的肾脏评分较高与肾小管间质损害加重的风险较高相关。

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    2019-07-02 villahu

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