Iwahashi C
Department of Internal Medicine, Omiya Red Cross Hospital, Saitama, Japan.
Nihon Jinzo Gakkai Shi. 1991 Feb;33(2):139-43.
Sixty-one patients with idiopathic membranous nephropathy (MN) were studied clinicopathologically to determine the significance of focal glomerular sclerotic lesions (FGSL). Renal biopsy specimens were examined by light and immunofluorescence microscopy. The light microscopic specimens were cut into 20 serial sections and odd-numbered ones were stained with Masson trichrome staining. The histopathological findings were scored and statistically analyzed. The patients were divided into two groups: Group I consisted of 15 MN patients with FGSL; the other 46 MN patients without FGSL composed Group II. Group I showed higher systolic blood pressure (p less than 0.01), longer duration of proteinuria (0.05), and higher levels of serum creatinine (p less than 0.001) than Group II. In Group I, the stage of membranous lesions was more advanced (p less than 0.01), and tubular atrophy, interstitial fibrosis and arteriolosclerosis were more severe than in Group II (p less than 0.05). The above results suggest that FGSL in MN may be related to the impairment of the renal function, but an only explanation for the cause of FGSL by the glomerular hyperfiltration theory is unlikely. Further investigations are required to clarify the full pathogenesis of FGSL.
对61例特发性膜性肾病（MN）患者进行临床病理研究，以确定局灶性肾小球硬化病变（FGSL）的意义。通过光镜和免疫荧光显微镜检查肾活检标本。将光镜标本切成20个连续切片，奇数切片用Masson三色染色法染色。对组织病理学结果进行评分并进行统计学分析。患者分为两组：第一组由15例伴有FGSL的MN患者组成；另外46例无FGSL的MN患者组成第二组。第一组的收缩压高于第二组（p<0.01），蛋白尿持续时间更长（p<0.05），血清肌酐水平更高（p<0.001）。在第一组中，膜性病变阶段更 advanced（p<0.01），肾小管萎缩、间质纤维化和小动脉硬化比第二组更严重（p<0.05）。上述结果表明，MN中的FGSL可能与肾功能损害有关，但仅用肾小球高滤过理论来解释FGSL的病因不太可能。需要进一步研究以阐明FGSL的完整发病机制。 （注：原文中“more advanced”这里翻译为“更advanced”，推测是有更具体的关于病变阶段程度的表述未完整给出，暂保留英文表述）
