内科2025，Vol.20Issue(4)：341-349,9.DOI:10.16121/j.cnki.cn45-1347/r.2025.04.01
系统性红斑狼疮患者合并与不合并狼疮性肾炎的临床特征对比:一项单中心横断面研究
Comparison of clinical characteristics between systemic lupus erythematosus patients with and without lupus nephritis:a single-center cross-sectional study
摘要
Abstract
Objective To compare the demographic,clinical,and serological characteristics between systemic lupus erythematosus(SLE)patients with and without lupus nephritis(LN),and to preliminarily explore a multifactorial association model related to the presence of LN.Methods A cross-sectional study design was used to retrospectively analyze the data of 712 hospitalized SLE patients at Shenzhen People's Hospital from August 2012 to August 2022.According to the presence of LN,patients were divided into an LN group(n=275)or a non-LN group(n=437).The t-test,Mann-Whitney U test,or χ² test was used for intergroup comparisons,as appropriate.Subsequently,to explore multifactorial associations,variables with statistical significance in the univariate analysis were included in a logistic regression model.Results Among the 712 SLE patients,275(38.62％)had LN.Univariate analysis results showed that the LN group had younger age and lower values than the non-LN group in terms of hemoglobin level,hematocrit,serum albumin level,serum globulin level,albumin/globulin ratio,glomerular filtration rate,complement C3 level,serum immunoglobulin(Ig)A level,serum IgG level,as well as the proportions of patients negative for anti-dsDNA antibody,anti-nucleosome antibody,anti-histone antibody,anti-Sm antibody,and anti-U1-snRNP antibody;conversely,the LN group had higher values than the non-LN group in terms of 24-hour urinary protein quantification,white blood cell count,neutrophil percentage,erythrocyte sedimentation rate,blood urea nitrogen level,serum creatinine level,serum total cholesterol level,low-density lipoprotein cholesterol level,systemic lupus erythematosus disease activity index(SLEDAI),systemic lupus erythematosus disease activity score(SLE-DAS),as well as the proportions of patients with hypertension,cardiovascular involvement,pericardial effusion,hematuria,pyuria,proteinuria,digestive system involvement,mesenteric vasculitis,ascites,hematological involvement,and lymphocytosis(all P<0.05).Results of multivariate logistic regression analysis showed that decreased complement C3 level,decreased serum IgG level,decreased serum IgA level,elevated SLE-DAS,positivity for anti-histone antibody,and positivity for anti-U1-snRNP antibody were independently and statistically associated with the presence of LN in SLE patients(all P<0.05).Conclusions SLE patients with LN exhibit significant differences in clinical characteristics compared to those without LN.Those with LN generally present with a more active immune status(consumptive decrease in complement C3),more severe renal damage manifestations(e.g.,higher prevalence of proteinuria and hypertension),and higher SLE-DAS.The multivariate model further outlines the intrinsic associative structure among these features,providing important preliminary evidence and a theoretical basis for validating the predictive value of these indicators in future prospective cohorts.关键词
系统性红斑狼疮/狼疮性肾炎/临床特征/免疫球蛋白/补体/疾病活动度Key words
Systemic lupus erythematosus/Lupus nephritis/Clinical characteristics/Immunoglobulin/Complement/Disease activity分类
医药卫生引用本文复制引用
高淑君,刘红阳,陈嫣然,赵倩倩,洪小平..系统性红斑狼疮患者合并与不合并狼疮性肾炎的临床特征对比:一项单中心横断面研究[J].内科,2025,20(4):341-349,9.基金项目
深圳市人民医院临床研究项目(SYWGSLCYJ202203) （SYWGSLCYJ202203）
