Croker B P, Lee T, Gunnells J C
Hum Pathol. 1987 Jan;18(1):38-44. doi: 10.1016/s0046-8177(87)80191-0.
This study supports the concept that primary necrotizing and crescentic glomerulonephritis is a kidney-limited form of polyarteritis nodosa. Thirty-four patients with necrotizing and crescentic glomerulonephritis were divided into three groups based on the presence or absence of systemic vasculitis as determined by clinical or histologic criteria. Laboratory studies demonstrated elevated erythrocyte sedimentation rates, anemia, mild eosinophilia, hematuria, and proteinuria in patients in each group; there were no significant differences in these data between the groups, however. Complement levels and antinuclear antibody screens were normal. Mean serum creatinine levels were markedly elevated but fell by a factor of two following therapy. There was a higher morbidity in the patients with kidney-limited disease. This was attributable to a higher percentage of these patients' having no symptoms and presenting for medical care only after they were in chronic renal failure. Most patients not experiencing chronic renal failure were treated with cyclophosphamide and prednisone, which seemed effective in this retrospective study.
本研究支持这样一种概念，即原发性坏死性新月体性肾小球肾炎是结节性多动脉炎的一种肾脏局限性形式。根据临床或组织学标准确定是否存在系统性血管炎，将34例坏死性新月体性肾小球肾炎患者分为三组。实验室研究表明，每组患者的红细胞沉降率升高、贫血、轻度嗜酸性粒细胞增多、血尿和蛋白尿；然而，这些数据在各组之间没有显著差异。补体水平和抗核抗体筛查均正常。平均血清肌酐水平显著升高，但治疗后下降了一半。肾脏局限性疾病患者的发病率较高。这是因为这些患者中无症状且仅在慢性肾衰竭后才就医的比例较高。大多数未发生慢性肾衰竭的患者接受了环磷酰胺和泼尼松治疗，在这项回顾性研究中，这两种药物似乎有效。
