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[慢性肾小球肾炎合并动脉血压升高患者的临床形态学比较]

[Clinico-morphological comparisons in patients with chronic glomerulonephritis and elevated arterial pressure].

作者信息

Gadaev A G, Akimova S L

出版信息

Urol Nefrol (Mosk). 1993 Sep-Oct(5):33-6.

PMID:8310582
Abstract

The study assessed functional condition and restructuring of renal tissues, correlations between some clinical and morphological parameters in 250 patients suffering from chronic glomerulonephritis (CGN) with secondary hypertension (SH) and in 47 CGN patients with isolated urinary syndrome (IUS). Mesangioproliferative glomerulonephritis (MSPG) was diagnosed in 173 patients (143 with SH, 30 with IUS), membrano-proliferative glomerulonephritis (MPG) in 69 (56 with SH and 13 with IUS), membranous glomerulonephritis in 37 patients (33 with SH, 4 with IUS), focal-segmentary with SH in 11 and minimal glomerulonephritis in 7 patients. The comparison revealed significant differences in arterial pressure (AP) and more severe renal lesions in SH than in IUS. The analysis of renal tissue restructuring showed SH patients to develop vascular and tubulointerstitial disorders along with glomerular hyalinosis indicative of AP rise with progressing sclerotic involvement specific for various morphological forms. This is confirmed by a significant correlation between glomerular hyalinosis and AP in MSPG with SH and MPG with SH, while in other morphological forms these are absent. The results suggest dissimilar mechanisms of SH progression in various CGN morphological patterns.

摘要

该研究评估了250例患有慢性肾小球肾炎(CGN)合并继发性高血压(SH)的患者以及47例患有孤立性尿综合征(IUS)的CGN患者的肾脏组织功能状况和重构情况,以及一些临床和形态学参数之间的相关性。173例患者被诊断为系膜增生性肾小球肾炎(MSPG)(143例合并SH,30例合并IUS),69例为膜增生性肾小球肾炎(MPG)(56例合并SH,13例合并IUS),37例为膜性肾小球肾炎(33例合并SH,4例合并IUS),11例为局灶节段性肾小球肾炎合并SH,7例为轻微肾小球肾炎。比较发现,SH组的动脉压(AP)和肾脏病变比IUS组更严重。对肾脏组织重构的分析表明,SH患者除了出现肾小球玻璃样变外,还会出现血管和肾小管间质疾病,这表明随着各种形态学形式中硬化性病变的进展,AP会升高。MSPG合并SH和MPG合并SH中肾小球玻璃样变与AP之间存在显著相关性,而在其他形态学形式中则不存在,这证实了上述情况。结果表明,在各种CGN形态学模式中,SH进展的机制不同。

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