Girndt J, Scheler F, Bohle A
Dtsch Med Wochenschr. 1978 Feb 3;103(5):199-204. doi: 10.1055/s-0028-1104406.
The clinical course of the haemolytic-uraemic syndrome in four patients suggests that hypertension may result from it. The morphological changes in the kidney are those of primary malignant nephrosclerosis. Hypercoagulability is thought to be an important pathogenetic factor in the development of the disease. But irreversible renal failure is not, contrary to typical primary malignant nephrosclerosis, an inevitable sequel. Abortive forms with predominant involvement of glomerular vessels have a more favourable prognosis than those forms with additional preglomerular vascular changes, in which a more or less marked impairment of renal function and hypertension persists. These forms are of particular interest because they indicate a renal pathogenetic mechanism of chronic hypertension. The described observations--taken together with those on the pathogenesis of hypertension caused by oral contraceptives--provide a pointer to the importance of clotting disorders in the initiation and development of some forms of hypertension.
4例溶血尿毒综合征患者的临床病程提示高血压可能由此引起。肾脏的形态学改变是原发性恶性肾硬化的改变。高凝状态被认为是该疾病发生发展的一个重要致病因素。但与典型的原发性恶性肾硬化不同,不可逆肾衰竭并非必然结局。以肾小球血管受累为主的顿挫型比伴有球前血管额外改变的类型预后更好,后者会持续存在或多或少明显的肾功能损害和高血压。这些类型特别值得关注,因为它们提示了慢性高血压的肾脏致病机制。上述观察结果——与口服避孕药所致高血压的发病机制观察结果相结合——为凝血障碍在某些类型高血压的发生和发展中的重要性提供了线索。