Kida H, Yoshimura M
Department of Internal Medicine, Kanazawa National Hospital.
Nihon Rinsho. 1995 Aug;53(8):2034-9.
Renal arterial disease-induced tubulo-interstitial lesions described in this chapter include benign arterio- and/or arteriolo-sclerotic and malignant nephrosclerosis, renal infarction and renal cortical necrosis. In these conditions renal glomeruli as well as tubules are always involved, and consequent loss of nephrons, or renal parenchyma results in interstitial fibrotic changes. The parenchymal lesions have a spectrum from slowly progressive atrophy and loss to necrosis of abrupt onset and disappearance of glomeruli and tubules. As for glomerular reactions to the ischemia, the intermediate type consisted of mesangial degeneration and epithelial cell proliferation described as "alterative glomerulitis" is noteworthy. Briefly, in renal arterial diseases, glomeruli are rather variably involved than tubules and loss of the parenchyma results in interstitial fibrosis.
本章所述的肾动脉疾病引起的肾小管间质病变包括良性小动脉和/或小动脉粥样硬化及恶性肾硬化、肾梗死和肾皮质坏死。在这些情况下,肾小球和肾小管均会受累,随之而来的肾单位或肾实质的丧失会导致间质纤维化改变。实质病变范围从缓慢进展的萎缩和丧失到突然发生的坏死,以及肾小球和肾小管的消失。至于肾小球对缺血的反应,值得注意的是由系膜变性和上皮细胞增殖组成的中间类型,被描述为“替代性肾小球肾炎”。简而言之,在肾动脉疾病中,肾小球受累的程度比肾小管更具变异性,实质的丧失会导致间质纤维化。