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原发性局灶节段性肾小球硬化症肾活检结果与临床表现的相关性

Correlation of kidney biopsy findings and clinical manifestations of primary focal and segmental glomerulosclerosis.

作者信息

Taheri Diana, Chehrei Ali, Samanianpour Pargol, Hassanzadeh Amar, Sadrarhami Shohreh, Seyrafian Shiva

机构信息

Department of Pathology, University of Medical Sciences, Isfahan, Iran.

出版信息

Saudi J Kidney Dis Transpl. 2009 May;20(3):417-23.

Abstract

To evaluate the correlation of clinical, laboratory, and pathological features at pre-sentation of focal segmental sclerosis (FSGS), we reviewed in a cross sectional study the pathological findings of kidney biopsies in 64 cases of primary FSGS, and correlated them with the clinical and laboratory data obtained at the time of the biopsies. The data included blood pressure, glomerular filtration rate (GFR), serum albumin, and the level of proteinuria. The mean level of serum creatinine was significantly higher in the biopsies' findings of synechiae (adhesions) in the Bowman's capsule, interstitial fibrosis, and global scars (P< 0.05), and mean level of GFR was significantly lower with the presence of interstitial fibrosis (P< 0.05). Furthermore, there was a positive correlation between the level of serum creatinine and global sclerosis (r= 2.21, P= 0.04), and a negative correlation between the level of GFR and global sclerosis(r= 2.01, P= 0.02). All the patients with renal insufficiency had interstitial fibrosis in their biopsies in comparison of only the 24 patients (48%) of the group without renal insufficiency (P< 0.05). There was no significant difference between patients with and without hypertension and nephritic-ranged proteinuria. We conclude that we found a correlation of renal insufficiency in primary FSGS patients with interstitial fibrosis, global scars and the synechiae of Bowman's capsule in their biopsies.

摘要

为评估局灶节段性肾小球硬化(FSGS)初诊时临床、实验室及病理特征之间的相关性,我们在一项横断面研究中回顾了64例原发性FSGS患者肾活检的病理结果,并将其与活检时获得的临床和实验室数据进行关联分析。数据包括血压、肾小球滤过率(GFR)、血清白蛋白及蛋白尿水平。在肾活检结果显示有Bowman囊粘连、间质纤维化及全球性瘢痕的患者中,血清肌酐平均水平显著更高(P<0.05),而存在间质纤维化时GFR平均水平显著更低(P<0.05)。此外,血清肌酐水平与全球性硬化之间呈正相关(r=2.21,P=0.04),GFR水平与全球性硬化之间呈负相关(r=2.01,P=0.02)。与无肾功能不全组中仅24例患者(48%)相比,所有肾功能不全患者的活检均有间质纤维化(P<0.05)。有高血压和肾病范围蛋白尿的患者与无此类情况的患者之间无显著差异。我们得出结论,原发性FSGS患者的肾功能不全与活检中的间质纤维化、全球性瘢痕及Bowman囊粘连相关。

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