Bohle A, Biwer E, Christensen J A
Institute of Pathology, University of Tübingen, FRG.
Am J Nephrol. 1988;8(3):179-86. doi: 10.1159/000167579.
Investigations of biopsy material from human kidneys with different forms of glomerulonephritis (n = 1,240) and with diabetic glomerulosclerosis (n = 406) performed in order to find changes caused by hyperperfusion of the kidney tissue gave the following results: (1) Hyperperfusion injury occurs in the different forms of glomerulonephritis with varying frequency. It was rarely found in immunologically negative mesangioproliferative glomerulonephritis. The highest incidence was found in patients with membranoproliferative glomerulonephritis type I. (2) Hyperperfusion injury was also found in kidneys with diabetic glomerulosclerosis. The frequency of this finding increased with the degree of the diabetic changes. (3) The hyperperfusion injury was seen as a complication of glomerulonephritis or diabetic glomerulosclerosis only when the patient clinically had developed malignant hypertension and when the serum creatinine level was elevated, a sign of compensated retention. (4) In patients with glomerulonephritis, the hyperperfusion changes occurred more frequently in males than in females. Diabetic glomerulosclerosis was complicated by hyperperfusion injury with the same frequency in both sexes. (5) Patients with hyperperfusion changes of the kidneys always excrete large amounts of protein in the urine. (6) Hyperperfusion changes occur first in the juxtamedullary glomeruli. The intermediate glomeruli are affected later and the subcapsular glomeruli last.
为了找出肾组织高灌注所引起的变化，对患有不同类型肾小球肾炎（n = 1240）和糖尿病性肾小球硬化症（n = 406）的人类肾脏活检材料进行了研究，结果如下：（1）高灌注损伤在不同类型的肾小球肾炎中出现的频率各异。在免疫阴性的系膜增生性肾小球肾炎中很少发现。在Ⅰ型膜增生性肾小球肾炎患者中发病率最高。（2）在患有糖尿病性肾小球硬化症的肾脏中也发现了高灌注损伤。这一发现的频率随糖尿病病变程度的增加而升高。（3）仅当患者临床上出现恶性高血压且血清肌酐水平升高（代偿性潴留的迹象）时，高灌注损伤才被视为肾小球肾炎或糖尿病性肾小球硬化症的并发症。（4）在患有肾小球肾炎的患者中，高灌注变化在男性中比在女性中更频繁出现。糖尿病性肾小球硬化症并发高灌注损伤在两性中的频率相同。（5）肾脏出现高灌注变化的患者总是尿中排出大量蛋白质。（6）高灌注变化首先出现在近髓肾小球。中间肾小球随后受到影响，而被膜下肾小球最后受到影响。
