目的 分析影响狼疮肾炎发展至尿毒症的各类危险因素,探讨预防和减缓狼疮肾炎病情加重的临床措施.方法 选择38例确诊狼疮肾炎的患者,观察期内,有23例发展为尿毒症.采用单因素及多因素Logistic回归分析其影响因素.结果 单因素Logistic回归分析提示:高血压史、血肌酐>133 μmol/L、尿素氮>6.5mmol/L、SLEDAI> 10分、GFR降低、尿蛋白>2g是狼疮肾炎发展为尿毒症的危险因素(P<0.05);多因素Logistic回归分析表明:血肌酐>133 μmol/L、高血压史、GFR降低、SLEDAI> 10分为狼疮肾炎发展为尿毒症的独立的危险因素(P<0.05).尿毒症患者三年累计病死率(43.48%)远高于病情稳定组患者(6.67%)(P<0.05).结论 应积极控制血压,减少脂肪摄入,低蛋白、低磷饮食为主,结合药物治疗等综合预防措施预防狼疮肾炎患者发生尿毒症.
Objective To investigate the risk factors of the development of uremia in lupus nephritis. Methods 38 patients diagnosed as lupus nephritis were selected. In the observation period, 23 patients developed uremia. Univariate and multivariate Logistic regression analysis of its influencing factors were conducted. Results History of hypertension, serum creatinine 〉133 μmol/L, urea nitrogen〉6.5mmol/L, SLEDAI〉 10, GFR decreased, proteinuria 〉2g were the risk factors of lupus nephritis development of uremia (P〈0.05). Serum creatinine 〉 133 μmol/L, history of hyperten- sion, GFR decreased, SLEDAI〉10 were the independent risk factors for the development of uremia (P〈0. 05). Three- year cumulative mortality of uremic patients (43.48%) was much higher than that of the stable patients (6.67 %) (P〈0.05). Conclusion Controlling blood pressure, reducing fat intake, having low protein and low phosphorus diet, combi- ning with drug treatment should be conducted to prevent the occurrence of uremic in patients with lupus nephritis.