Athanasou N A, Ayers D, Rainey A J, Oliver D O, Duthie R B
Nuffield Department of Pathology, University of Oxford, John Radcliffe Hospital.
Q J Med. 1991 Mar;78(287):205-14.
Deposition of beta 2-microglobulin amyloid in the joints of dialysis patients is common and begins early in the course of treatment, but its pathogenic significance in the production of dialysis arthropathy is uncertain. The joints (hip, knee, shoulder, elbow, wrist, cervical and lumbar spine, sacroiliac joint) and systemic tissues of 19 autopsied patients who had undergone haemodialysis for between 6 and 231 months were examined histopathologically for the presence of beta 2-microglobulin amyloid; it was present in all joints examined, including those unassociated with radiological changes and those of patients who had been on haemodialysis alone for only 24 months. Osteoarticular beta 2-microglobulin amyloid deposits were also found in patients who had been treated mainly by continuous ambulatory peritoneal dialysis. Systemic amyloid deposition was only seen in patients who had been haemodialysed for more than 13 years and consisted of sparse tiny deposits in blood vessel walls.
β2-微球蛋白淀粉样物质在透析患者关节中的沉积很常见，且在治疗过程早期就开始出现，但其在透析性关节病产生中的致病意义尚不确定。对19例接受血液透析6至231个月的尸检患者的关节（髋、膝、肩、肘、腕、颈椎和腰椎、骶髂关节）及全身组织进行了组织病理学检查，以确定是否存在β2-微球蛋白淀粉样物质；在所检查的所有关节中均发现了该物质，包括那些与放射学改变无关的关节以及仅接受血液透析24个月的患者的关节。主要接受持续性非卧床腹膜透析治疗的患者也发现有骨关节β2-微球蛋白淀粉样物质沉积。全身性淀粉样物质沉积仅见于接受血液透析超过13年的患者，表现为血管壁上稀疏的微小沉积物。
