目的

探讨男性狼疮肾炎（LN）导致急性肾衰竭（ARF）的临床表现、肾脏病理特点和预后。

方法

回顾性分析卫生部中日友好医院2003年4月至2011年6月收治的29例表现ARF的男性LN患者的临床表现、肾脏病理特点及预后随访结果。统计学计量资料以 表示，多组间比较采用方差分析；计数资料以频数和百分比表示，组间比较采用秩和检验。

结果

29例患者平均年龄为（31.7±11.5）岁（16 ～ 63岁），其中青年（≤45岁）25例，中年（46 ～ 64岁）4例。除有ARF表现外，26例患者伴有肾病综合征，占89.7%。29例患者肾脏病理类型：Ⅳ型22例（其中4例为新月体型肾炎），Ⅴ型1例，Ⅳ+Ⅴ型6例。治疗方案以糖皮质激素联合环磷酰胺治疗为主。至2011年12月共随访到21例患者，随访时间6 ～ 68个月，结果显示57.1%（12/21）患者已经为慢性肾衰竭，其中1例死亡；42.9%（9/21）患者肾功能恢复了正常。

结论

男性LN表现ARF的患者以青年人多见，多数伴有肾病综合征，肾脏病理表现多数较重，但经过治疗部分患者肾功能可恢复正常。

Objective

To explore the clinical manifestation, renal pathology and prognosis characteristics in acute renal failure (ARF) caused by lupus nephritis (LN) in male patients.

Methods

Between April, 2003 and June, 2011 29 male LN patients with ARF were retrospectively reviewed for clinical manifestation, renal pathology and prognosis.

Results

Age of the patients were (31.7±11.5)years old (age range 16 - 63), among all the 29 patients, there were 25 young (≤45 years old) and 4 middle-aged (46 - 64) years old. Besides ARF, 26 (89.7%) patients had nephrotic syndrome, and the signs of other organs involvement were found. Renal biopsy was performed in all patients. The pathology results were: 22 patients with class Ⅳ (crescentic glomerulonephritis in 4), 1 patient with classⅤ, 6 patients with classⅣ and Ⅴ. The main treatment was glucocorticoids in combination with cyclophosphamide. Follow up was available in 21 patients for a period of 6 - 68 months until December, 2011. There was 1 patient died, 57.1% of the patients developed chronic renal failure and renal function recovered to normal in 42.9% of the patients.

Conclusion

There were more young patients in male LN patients with ARF. Most of them with nephrotic syndrome, and more with severe renal pathologic classification; but in 42.9% of the patients, the renal function recovered.