nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-3178Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESСистемная красная волчанка с поражением почек: клиническая характеристика и опыт лечения в нефрологическом отделении ГКБ им. С.П. Боткина за период с 1991 по 2001 ггSystemic Lupus Erythematosus with renal involvement: clinical features and experience of treatment in the Division of Nephrology of Botkin City hospital (1991-2001)МихайловаН. А.MikhailovaN. A.noemail@neicon.ruЗахароваЕ. В.ZakharovaE. V.noemail@neicon.ruИпатьеваЕ. И.IpatievaE. I.noemail@neicon.ruТарееваЕ. И.TareevaE. I.noemail@neicon.ruВиноградоваО. В.VinogradovaO. V.noemail@neicon.ruРоссийская медицинская академия последипломного образованияRussian FederationГКБ им. С.П. Боткина, г. МоскваRussian Federation20022806202543186191Copyright © Михайлова Н.А., Захарова Е.В., Ипатьева Е.И., Тареева Е.И., Виноградова О.В., 20252025Михайлова Н.А., Захарова Е.В., Ипатьева Е.И., Тареева Е.И., Виноградова О.В.Mikhailova N.A., Zakharova E.V., Ipatieva E.I., Tareeva E.I., Vinogradova O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/3178

В статье представлен ретроспективный анализ историй болезни 32 из 50 больных системной красной волчанкой с поражением почек, лечившихся в нефрологическом отделении ГКБ им. С.П. Боткина в период 1991-2001 гг. У 11 больных имел место нефритический, у 21 - нефротический тип нефрита. Среди экстраренальных проявлений наиболее часто отмечались поражения системы крови, кожи, суставов, ЦНС и легких. Монотерапия глюкокортикоидами (ГК) проводилась 6 больным (в связи с наличием противопоказаний к назначению цитостатиков). Остальные, помимо ГК в высоких дозах, получали цитостатики (ЦС). За время наблюдения умерло 9 больных (18%). Статистический анализ лабораторных и клинических показателей выявил ряд достоверных закономерностей: поражение ЦНС коррелирует с поражением легких; неблагоприятные исходы чаще наблюдаются у лиц старше 40 лет; тип нефрита и его активность не являются предикторами летальности, в то время как активность экстраренальных проявлений влияет на исход заболевания; среди причин смерти не было уремии.

A retrospective analysis of 32 from 50 cases of Systemic Lupus Erythematosus (SLE) with renal involvement, treated in the Division of Nephrology of Moscow Botkin City hospital between 1991 and 2001 was performed. 11 patients had a nephritic type of nephritis, and 21 patients - a nephrotic type. The more often extrarenal involvement were lesions of blood, skin, joints, brain and lung. 6 patients were treated with glucocorticoids (GC) only (because of contraindications to cytostatics). Others, in addition to the high doses of GC received also cytostatics (CS). CS treatment leads to the better kidney survival. 9 patients (18%) died during the period of observation. Statistical analysis of clinical and laboratory data revealed a number of authentic normalities. Involvement of central nervous system correlates with lung lesions, unfavourable outcome is more often among persons elder then 40. The type of nephritis and its activity proved not to be the predictors of death, while the activity of extrarenal involvement influences on the outcome of the disease. There were no cases of uremia among the causes of death.

системная красная волчанка (СКВ)волчаночный нефритиммуносупрессивная терапияReferencesСоловьева С.К., Насонова В.А. Современные представления об интенсивной терапии системной красной волчанки. Русский медицинский журнал 2000; 6; 18: 1195-1198.Соловьева С.К., Насонова В.А. Современные представления об интенсивной терапии системной красной волчанки. Русский медицинский журнал 2000; 6; 18: 1195-1198.Bansal V.K., Beto J.A. Treatment of lupus nephritis: a meta-analysis of clinical trials. Amer J Kidney Dis 1997; 29; 2: 193-199.Bansal V.K., Beto J.A. Treatment of lupus nephritis: a meta-analysis of clinical trials. Amer J Kidney Dis 1997; 29; 2: 193-199.Boumpas D.T., Austin H.A., Vaughn E.M. et al. Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis. The Lancet 1992; 340: 741-745.Boumpas D.T., Austin H.A., Vaughn E.M. et al. Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis. The Lancet 1992; 340: 741-745.Castier M.B., Albuquerque E.M.N., Menezes M.E.F.C. et al. Cardiac Tamponade in Systemic Lupus Erythematosus. Report of Four Cases. Arq Bras Cardiol 2000; 75; 5: 446-448.Castier M.B., Albuquerque E.M.N., Menezes M.E.F.C. et al. Cardiac Tamponade in Systemic Lupus Erythematosus. Report of Four Cases. Arq Bras Cardiol 2000; 75; 5: 446-448.Cely C., Stollman N.H. Lupus abdominal crisis owing to rupture of an ileocolic aneurysm with successful angiographic treatment. J Clin Gastroenterol 2001; 32; 4: 347-350.Cely C., Stollman N.H. Lupus abdominal crisis owing to rupture of an ileocolic aneurysm with successful angiographic treatment. J Clin Gastroenterol 2001; 32; 4: 347-350.Hayslett J.P., Esdaile J.M. Response to therapy as a predictor of outcome in lupus. Clin and Invest Med 1992; 15; 4: 145.Hayslett J.P., Esdaile J.M. Response to therapy as a predictor of outcome in lupus. Clin and Invest Med 1992; 15; 4: 145.Illei G.G., Austin H.A., Crane M. et al. Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis. Ann Intern Med 2001; 135; 4: 296-298.Illei G.G., Austin H.A., Crane M. et al. Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis. Ann Intern Med 2001; 135; 4: 296-298.Mok C.C., Lau C.S., Chan E.Y.T. et al. Acute transverse myelopathy in SLE: Clinical Presentation, Treatment and outcome. J of Rheumatol 1998; 25; 3: 467-473.Mok C.C., Lau C.S., Chan E.Y.T. et al. Acute transverse myelopathy in SLE: Clinical Presentation, Treatment and outcome. J of Rheumatol 1998; 25; 3: 467-473.Mok C.C., Lau C.S., Wong R.W. Neuropsychiatric manifestations and their clinical associations in southern chinese patients with systemic lupus erythematosus. J Rheumatol 2001; 28; 4: 766-771.Mok C.C., Lau C.S., Wong R.W. Neuropsychiatric manifestations and their clinical associations in southern chinese patients with systemic lupus erythematosus. J Rheumatol 2001; 28; 4: 766-771.Mok C.C., Ho C.T., Sin Y.P. et al. Treatment of diffuse proliferative lupus glomerulonephritis: a comparison of two cyclophosphamide-containing regimens. Am J Kidney Dis 2001; 38; 2: 256-264.Mok C.C., Ho C.T., Sin Y.P. et al. Treatment of diffuse proliferative lupus glomerulonephritis: a comparison of two cyclophosphamide-containing regimens. Am J Kidney Dis 2001; 38; 2: 256-264.Mosca M., Neri R., Gianessi S. et al. Therapy with pulse methylprednisolone and short-course pulse cyclophosphamide for diffuse proliferative glomerulonephritis. Lupus 2001; 10; 4: 253-257.Mosca M., Neri R., Gianessi S. et al. Therapy with pulse methylprednisolone and short-course pulse cyclophosphamide for diffuse proliferative glomerulonephritis. Lupus 2001; 10; 4: 253-257.Paton N.I.J., Cheong I.K.S., Kong N.C.T. et al. Risk factors for infections in Malaysian patients with SLE. Q J Med 1996; 89: 531-538.Paton N.I.J., Cheong I.K.S., Kong N.C.T. et al. Risk factors for infections in Malaysian patients with SLE. Q J Med 1996; 89: 531-538.Pinto L.F., Senior J.M., Ceron J.A. et al. Nefropatia lupica. Acta Medica Colombiana 1992; 18; 3: 157-163.Pinto L.F., Senior J.M., Ceron J.A. et al. Nefropatia lupica. Acta Medica Colombiana 1992; 18; 3: 157-163.Robert E., Parodi A., Rebora A. An Unusual Dermatologic Presentation of Systemic Lupus Erythematosus. Int J Dermatol 1992; 31; 2: 14.Robert E., Parodi A., Rebora A. An Unusual Dermatologic Presentation of Systemic Lupus Erythematosus. Int J Dermatol 1992; 31; 2: 14.

The authors declare that there are no conflicts of interest present.