【摘要】在狼疮性肾炎中，肾脏微血管病变普遍存在，在肾穿刺病理活检下主要分为免疫复合物沉积型、动脉硬化型、血栓性微血管病型、非炎症性坏死性血管病变型和真性血管炎型五种类型。肾微血管病变与疾病临床活动度、肾脏预后密切相关，并影响治疗方案的选择。其主要发病机制涉及内皮细胞活化、损伤，和免疫系统功能异常等多方面。针对其发病机制开展个体化的精准治疗是目前临床工作的迫切需求。

【Abstract】Renal vascular lesions are common in lupus nephritis. There are five major pathological types in renal biopsy samples: vascular immune complex deposits, arteriosclerosis, thrombotic microangiopathy, non-inflammatory necrotizing vasculopathy, and true renal vasculitis. They are correlated with disease activity, renal outcome and therapeutic strategy. The key mechanisms include endothelial cell activation and dysfunction, and immune system disorders. Moreover, mechanism- based individualized therapies for lupus nephritis are required.