关键词: 狼疮性肾炎, 蛋白尿, 足细胞

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To investigate the correlation of  proteinuria and renal lesion in lupus nephritis(LN)patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：Clinical and pathological data of renal biopsy proven LN patients were collected from May 1,2008 to March 1,2014 from our renal pathology database.Correlation analysis was made between the different types of renal injury in LN and proteinuria.
Ｒｅｓｕｌｔｓ：There were significant differences between 24h proteinuria and the six pathology types in the 121 LN patients (P<005).The level of 24 hours proteinuria was related to the degree of crescent (P=0049),the degree of subepithelial electrondense deposits  (P<0001) and the degree of podocyte lesion(P<0001).And these three renal lesions were all positively correlated with  proteinuria.There was no statistical difference between 24h proteinuria and  the deposition of electron dense substance in mesangial area,mesangial cells and matrix hyperplasia,endothelial cell proliferation and subendothelial electrondense deposits.After controlling the constant parameters of sex,age,BMI,ALB,multivariate linear regression analysis suggested that the degree of podocyte  lesion was the only factor which was correlated with the 24h proteinuria (P<0001).The level of 24h proteinuria had a predictive value for the degree of podocyte injury(AUC 855%,P<0001),and its specificity was 100%,and the sensitivity was 426%.
Ｃｏｎｃｌｕｓｉｏｎ：The level of proteinuria in LN patients is related to the degree of podocyte injury in renal pathological changes.The degree of proteinuria increases with the increase of podocyte injury or  basilar membrane destruction.The level of 24h proteinuria has a high predictive value for the  histopathological damage of the podocyte.

Key words: lupus nephritis, proteinuria, podocyte