Serov V V
Vestn Ross Akad Med Nauk. 1995(5):43-7.
Many years' experience in studying chronic glomerulonephritis allows the author to consider it to be a group entity including mesangioproliferative, mesangiocapillary and sclerosing (fibroplastic) types of glomerulonephritis. Minimal changes, focal segmental glomerular sclerosis/hyalinosis, membranous nephropathy which have been previously included to a group of chronic glomerulonephritis should be excluded since they comprise another group of non-inflammatory glomerulopathies with primary podocytic damage. A group of mesangioproliferative glomerulonephritis (MPGN) is heterogeneous both in terms of pathogenetic parameters, on the one hand, and clinical and predictive parameters, on the other. Their clinical and morphological variants which differ with the nature of immunoglobulins in the glomerular immune complexes are presented as IgA-, IgM-, and IgG-MPGN, each of them pretends to an individual nosological entity. Mesangiocapillary glomerulonephritis (MCGN) as a nosological entity showing specific features of morphological, pathogenetic, and clinical manifestations and prognosis may be left only if dense deposit diseases are deducted, which owing to clinical, morphological and some pathogenetic features pretends to its independence. The morphological types of MCGN are either types (I and III) or form phases (I and IV) which reflect the progression of the disease. Sclerosing (fibroplastic) glomerulonephritis is an evolutive form which completes both MPGN and MCGN. There is strong evidence for the fact that the current nephrology concepts of nosological entities require reconsideration on the basis of new research findings.
多年来对慢性肾小球肾炎的研究经验使作者认为它是一个群体实体，包括系膜增生性、系膜毛细血管性和硬化性（纤维增生性）肾小球肾炎类型。微小病变、局灶节段性肾小球硬化/玻璃样变、膜性肾病，以前曾被归入慢性肾小球肾炎组，现在应排除在外，因为它们构成了另一组以原发性足细胞损伤为主的非炎症性肾小球病。系膜增生性肾小球肾炎（MPGN）组在致病参数方面以及临床和预测参数方面都是异质性的。它们的临床和形态学变异体因肾小球免疫复合物中免疫球蛋白的性质不同而有所差异，分别表现为IgA -、IgM -和IgG - MPGN，每一种都被认为是一个独立的病种实体。系膜毛细血管性肾小球肾炎（MCGN）作为一种具有形态学、致病机制、临床表现和预后等特定特征的病种实体，只有扣除致密沉积物病后才能保留，致密沉积物病由于其临床、形态学和一些致病特征而被认为具有独立性。MCGN的形态学类型要么是类型（I和III），要么是阶段（I和IV），它们反映了疾病的进展。硬化性（纤维增生性）肾小球肾炎是一种演变形式，是MPGN和MCGN的终末期表现。有充分证据表明，目前肾脏病学中关于病种实体的概念需要根据新的研究结果重新审视。
