| 摘要: |
| ［摘要］ 系统性红斑狼疮（SLE）是一种侵犯全身结缔组织的自身免疫性疾病，病变常累及多系统多脏器，肾脏是其最常受累的器官之一。一般情况下，临床上需先诊断为SLE、狼疮性肾炎（LN），肾脏病理才能诊断LN并分型。但在实际工作中，临床经常缺乏确诊SLE的依据，且肾脏病理不典型，就只能诊断为某种继发肾小球疾病，待数月或者数年之后，患者全身系统受累的病症出现才修正诊断为SLE。一旦没有进行早期诊断，就有可能延误治疗。随着对SLE认识的深入，SLE的诊断也在不断更新，从目前的更新来看，其最大的特点是更利于SLE的早期诊断。但对肾内科医师而言，更新的SLE诊断标准仍然没有解决，在没有确切的临床证据下，肾脏病理不提示典型LN，是否也能归类为LN的问题。 |
| 关键词: 系统性红斑狼疮 狼疮性肾炎 肾脏病理 |
| DOI：10.3969/j.issn.1674-3806.2019.07.03 |
| 分类号:R 593.24+1 |
| 基金项目:国家自然科学基金资助项目（编号：81870495） |
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| Renewal of diagnosis of systemic lupus erythematosus from the perspective of nephrologists |
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ZHUO Li
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Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China
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| Abstract: |
| ［Abstract］ Systemic lupus erythematosus(SLE) is an autoimmune disease that invades the connective tissue of the whole body. The lesions often involve multiple systems and organs. The kidneys are the most commonly affected organs. Under normal conditions, clinical diagnosis of SLE and lupus nephritis(LN) should be confirmed firstly, and renal pathology can diagnose and classify LN. However, in clinical practice, there is often a lack of evidence for diagnosis of SLE, and renal pathology is atypical. As a consequence, only a certain secondary glomerular disease can be diagnosed. Several months or years later, the diagnosis will be corrected to SLE after the appearance of systemic involvement. Once an early diagnosis is not made, treatment may be delayed. With the deepening understanding of SLE, the diagnosis of SLE is constantly updated. From the current update, its greatest feature is more conducive to the early diagnosis of SLE. However, for nephrologists, the updated diagnostic criteria for SLE still do not resolve the problems. Without definite clinical evidence and in the absence of renal pathological results suggesting typical LN, can it be classified as LN? |
| Key words: Systemic lupus erythematosus(SLE) Lupus nephritis(LN) Renal pathology |
