Ditscherlein G
Hypertension. 1985 Nov-Dec;7(6 Pt 2):II29-32. doi: 10.1161/01.hyp.7.6_pt_2.ii29.
A total of 250 renal biopsy specimens from diabetic patients and from the kidneys of 400 autopsy cases were examined histologically and compared to kidneys from 160 autopsied nondiabetics. The morphological findings were assessed in relation to hypertension. There was a high prevalence of arteriolosclerosis, glomerulosclerosis, and pyelonephritis; in addition, early diabetic glomerulopathy and glomerulonephritis, particularly of the membranous type, were noted in a remarkably high percentage of diabetic patients. Ninety-three percent of patients with hypertension had arteriolosclerosis, and a good correlation existed between the extent of this lesion and the level of blood pressure. Even in 66% of normotensive patients, however, arteriolosclerosis was found. This fact and the involvement of the vas efferens argue against the notion of arteriolosclerosis being exclusively a sequela of hypertension. More than 70% of patients with glomerulosclerosis suffered from hypertension, compared to less than 50% of patients without either that condition or early diabetic lesions. The majority of diabetic patients with pyelonephritis and glomerulonephritis were hypertensive. We conclude that hypertension in diabetic patients with renal involvement may result from different renal lesions that can be differentiated only by histological examination.
对250例糖尿病患者的肾活检标本以及400例尸检病例的肾脏进行了组织学检查，并与160例非糖尿病尸检者的肾脏进行了比较。根据高血压情况对形态学发现进行了评估。小动脉硬化、肾小球硬化和肾盂肾炎的患病率很高；此外，在相当高比例的糖尿病患者中发现了早期糖尿病肾小球病变和肾小球肾炎，尤其是膜性类型。93%的高血压患者患有小动脉硬化，并且这种病变的程度与血压水平之间存在良好的相关性。然而，即使在66%的血压正常的患者中也发现了小动脉硬化。这一事实以及出球小动脉的受累情况反驳了小动脉硬化仅仅是高血压后遗症的观点。患有肾小球硬化的患者中超过70%患有高血压，相比之下，没有这种情况或早期糖尿病病变的患者中这一比例不到50%。大多数患有肾盂肾炎和肾小球肾炎的糖尿病患者患有高血压。我们得出结论，患有肾脏病变的糖尿病患者的高血压可能由不同的肾脏病变引起，这些病变只能通过组织学检查来区分。
