系统性红斑狼疮(SLE)很常见,以肾脏受累为第一个表现难以诊断。本文分析111例SLE中以肾脏病为首发表现者22例(占20％)。狼疮性肾炎(LN)为SLE的首发表现常以肾病综合征(NS)为主,其病理主要是膜性和弥漫增殖性。血C_3下降、γ球蛋白与ANA升高和贫血有助于鉴别。LN急性发作、肾功能恶化、活动病变用MP冲击治疗预后好。 Systemic lupus erythematosus (SLE) is very common, with renal involvement as the first manifestation of difficult diagnosis. This article analyzes the 111 cases of SLE in kidney disease as the first performance in 22 cases (20%). Lupus nephritis (LN) is the first manifestation of SLE nephrotic syndrome (NS) -based, the main pathological membrane and diffuse proliferative. Blood C_3 decreased, γ-globulin and ANA increased and anemia contribute to the identification. LN acute attack, deterioration of renal function, active lesions with MP impact treatment of good prognosis.