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目的：探讨类风湿性关节炎（ＲＡ）肾脏损害的特点以及ＲＡ免疫学异常与肾脏受累的关系。方法：分析１１例ＲＡ患者的临床表现，肾活检病理资料及血清免疫学、血液生化及尿液分析等检查结果。结果：有明显肾损害临床表现者仅３例，但全部病例肾活检均有病理改变，组织学类型以系膜增生性肾炎为主。９例血清ＩｇＭ型类风湿因子（ＩｇＭ－ＲＦ）阳性，滴定度１∶２０～１∶３２０。ＩｇＭ－ＲＦ１∶４０以上阳性者，免疫荧光检查均显示系膜区和（或）血管袢有免疫球蛋白及补体成份沉积。结论：本组ＲＡ患者肾脏损害发生率高达１００％，系膜增生是其主要的病理改变，大部分病例肾脏病变与ＲＡ自身免疫学异常有关。
Objective: To investigate the characteristics of renal damage in rheumatoid arthritis (RA) and the relationship between RA immunological abnormalities and renal involvement. Methods: The clinical manifestations, pathological data of renal biopsy, serum immunology, blood biochemistry and urine analysis were analyzed in 11 RA patients. Results: There were only 3 cases with obvious clinical manifestations of renal damage, but pathological changes were found in all cases of renal biopsy. The main histological types were mesangial proliferative glomerulonephritis. 9 cases of IgM-type rheumatoid factor (IgM-RF) positive titer 1:20 ~ 1: 320. IgM-RF1: 40 or more positive, immunofluorescence showed mesangial area and (or) angiosperm immunoglobulin and complement component deposition. CONCLUSIONS: The incidence of renal damage in RA patients is as high as 100%. Mesangial proliferation is the major pathological change. In most cases, the renal lesions are related to the autoimmune abnormalities of RA.