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目的 研究狼疮性肾炎（ＬＮ）病人的长期生存率，并分析影响生存率的预后因素。方法 对１９８６年１２ 月～１９９６ 年１２ 月住院的３２６ 例ＬＮ病人进行回顾性分析，用寿命表分析生存率，采用Ｃｏｘ 模型分析预后因素。结果 ＬＮ病人１，５，１０ ａ 生存率分别为８８－３ ％ ，７４－５％ 及６０－２％ 。影响生存率的预后因素有高血压、浆膜炎，血清肌酐≥１２０ μｍｏｌ／Ｌ，系统性红斑狼疮疾病活动指数（ＳＬＥＤＡＩ） ≥２０ 分，尿细胞管型，Ｃ３ ＜ ０．８ ｇ／Ｌ及合并感染，其中血清肌酐升高，Ｃ３ 下降，ＳＬＥＤＡＩ≥２０ 分是独立的预后影响因素。激素加环磷酰胺治疗能提高生存率。结论 肾脏受损，Ｃ３ 下降及狼疮活动程度是影响ＬＮ预后的重要因素，积极的免疫抑制剂治疗有利于改善预后。
Objective To study the long-term survival rate of patients with lupus nephritis (LN) and to analyze the prognostic factors affecting the survival rate. Methods A retrospective analysis of 326 patients with LN who were hospitalized from December 1986 to December 1996 was conducted. Life expectancy was used to analyze the survival rate and Cox model was used to analyze the prognostic factors. Results The 1,5,10-year survival rate of patients with LN was 88-3%, 74-5% and 60-2%, respectively. Prognostic factors affecting survival were hypertension, serositis, serum creatinine ≥120 μmol / L, systemic lupus erythematosus disease activity index (SLEDAI) ≥20, urinary cell tube type, C3 <0.8 g / L and Infection, including serum creatinine, C3 decreased, SLEDAI ≥ 20 points is an independent prognostic factor. Hormone and cyclophosphamide treatment can improve survival. Conclusion The renal damage, the decrease of C3 and the degree of lupus activity are the important factors that affect the prognosis of LN. Positive immunosuppressive therapy is beneficial to improve the prognosis.