Mô bệnh học viêm thận lupus và một số yếu tố liên quan tại bệnh viện Bạch Mai=Pathology of lupus nephritis and related factors at Bach Mai hospital

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Tác giả: Thị Như Cao, Mạnh Long Đường, Tuấn Hùng Hà, Trung Dũng Nghiêm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.49-54

Bộ sưu tập: Metadata

ID: 242615

Thêm vào giỏ

Phân tích tổn thương trên mô bệnh học thận và tìm hiểu một số yếu tố liên quan ở bệnh viện viêm thận Lupus tại bệnh viện Bạch Mai Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang và hồi cứu trên bệnh nhân được sinh thiết thận và chẩn đoán viêm thận lupus trong giai đoạn từ 2015 đến 2024 Kết quả: 346 bệnh nhân được sinh thiết thận 301 nữ (87%) và 45 nam (13%), độ tuổi trung bình là 32,58±10,74. Loại mô bệnh học thận phổ biến nhất là Class IV (52,3%), tổn thương dạng lan tỏa là 62,4%. Tổn thương dạng hoạt động hay gặp nhất là tăng sinh tế bào nội mao mạch 73,1%, trong khi teo ống là tổn thương mạn tính phổ biến nhất 57,8%. Tình trạng thiếu máu, mức độ thiếu máu nặng hay gặp nhất ở class IV (p<
0,01), phận loại mức độ hoạt động AI và CI cao nhất trong nhóm class IV (p<
0,01), điểm AI, CI trung bình lần lượt là 6.02±3,52 và 2,16±1,87. Các chỉ số protein và albumin máu có sự liên quan đến class IV, các immuglobulin và bổ thể C3, C4, protein máu, albumin máu sụt giảm nhiều hơn ở class IV (p<
0,01). Kết luận: Trong nghiên cứu này, chúng tôi áp dụng mô hình và đặc điểm tổn thương mô bệnh học sinh thiết thận ở bệnh nhân VTL, hệ thống phân loại mô bệnh học theo ISN/RPS và hệ thống phân loại mức độ hoạt động và mạn tính theo NIH đều có một số tương quan với biểu hiện lâm sàng và cận lâm sàng. Việc xem xét các mối tương quan này giúp xác định tình trạng lâm sàng, tiên lượng và như cầu điều trị cho bệnh nhân. Vì vậy việc sinh thiết thận và phân tích các tổn thương mô bệnh học thận là cần thiết trong thực hành lâm sàng.To detemine renal histopathological lesions and investigate related factors in patients with lupus nephritis at Bach Mai Hospital. Patients and methods: A cross-sectional descriptive and retrospective study of patients who underwent renal biopsy and were diagnosed with lupus nephritis from 2015 to 2024. Results: A total of 346 patients underwent renal biopsy, including 301 females (87%) and 45 males (13%), with an average age of 32.58±10.74 years. The most common histopathological type was Class IV (52.3%), with diffuse lesions found in 62.4% of cases. The most frequent active lesion was endocapillary hypercellularity (73.1%), while tubular atrophy was the most common chronic lesion (57.8%). Anemia, particularly severe anemia, was most common in Class IV (p<
0.01). The highest AI and CI activity levels were found in Class IV (p<
0.01), with average AI and CI scores of 6.02±3.52 and 2.16±1.87, respectively. Serum protein and serum albumin levels were associated with class IV, with serum immunoglobulins and serum complement levels (C3, C4), as well as serum protein and albumin, being significantly reduced in class IV (p<
0.01). Conclusion: In this study, we identified patterns and characteristics of renal histopathological lesions in lupus nephritis patients. The ISN/RPS histopathological classification and the NIH activity and chronicity classification systems were correlated with clinical and laboratory findings. Understanding these correlations helps determine the clinical status, prognosis, and treatment needs of patients. Therefore, renal biopsy and histopathological analysis are essential in clinical practice.

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