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目的 研究高血压对狼疮肾炎 (LN)肾功能损害发展的影响。方法 对 5 33例成年LN病人采用回顾性群体研究。以LN发展到终末期肾病 (ESRD)的时间为衡量指标。采用寿命表分析研究高血压对LN患者肾功能发展到ESRD的影响。结果 5 33例患者平均随访时间为 7 8年 ,12 6例 (2 3 6 % )发展至ESRD。起病时伴随着高血压与ESRD的发展相关联。所有病例发展到ESRD的中位数时间分别为 ,重度高血压 (DBp >10 5mmHg) 8个月 ,轻度高血压 (DBp 90～ 10 4mmHg) 4 5个月 ,血压正常 112个月。多变量分析表明高血压独立影响着患者的预后 ,而患者的一般人口因素特点对ESRD的发展并无影响。结论 高血压是影响狼疮肾炎预后的重要的、潜在的可变因素。
Objective To study the effect of hypertension on the development of renal dysfunction in lupus nephritis (LN). Methods A retrospective population study was performed on 533 adult LN patients. The time to LN progression to end-stage renal disease (ESRD) was used as a measure. Analysis of the effect of hypertension on the development of renal function and ESRD in LN patients by life table analysis. Results The average follow-up time of 3333 patients was 78 years, and 126 cases (236%) progressed to ESRD. The onset of hypertension is associated with the development of ESRD. The median time to progression to ESRD in all cases was 8 months for severe hypertension (DBp> 10 mm Hg), 45 months for mild hypertension (DBp 90 to 104 mm Hg) and 112 months for normal blood pressure. Multivariate analysis showed that hypertension independently affected the prognosis of patients, and the characteristics of the general population of patients had no effect on the development of ESRD. Conclusion Hypertension is an important and potential variable factor affecting the prognosis of lupus nephritis.