Di Paolo N, Fineschi V, Di Paolo M, Wetly C V, Garosi G, Del Vecchio M T, Bianciardi G
Nephrology and Dialysis Department, University Hospital of Siena, Italy.
Clin Nephrol. 1997 May;47(5):298-303.
Cardiovascular damage is common in young cocaine addicts, and similar atherosclerotic lesions seem likely in the kidneys. To confirm this hypothesis, we performed histological examination of 40 kidney autopsy specimens classified as "cocaine-related deaths"; as controls, kidney specimens of 40 road accident victims were examined. Semiquantitative analysis showed that the ratio of the number of glomeruli affected by hyalinosis to the total number of glomeruli was 0.09 +/- 0.13 in addicts and 0.005 +/- 0.01 in controls; the difference was highly significant. The degree of periglomerular fibrosis was significantly higher in cocaine addicts than in accident victims. The ratio of glomeruli to tubular casts was 0.15 +/- 0.17 in cocaine addicts and 0.17 +/- 0.18 in controls (not significant). The degree of interstitial cellular infiltration was significantly higher in addicts than controls. A monunuclear cell infiltrate was observed prevalently in the medullary region. Arteriolar sclerosis was significantly higher in addicts than controls. Medial thickening, luminal narrowing and vessel obstruction were absent in the control group. Quantitative morphometric analysis of arterial structure showed significantly greater lumen circumference, intima circumference, media circumference, intima area, media area, intima thickness and media thickness in cocaine addicts than in controls.
心血管损伤在年轻的可卡因成瘾者中很常见，肾脏中似乎也可能出现类似的动脉粥样硬化病变。为了证实这一假设，我们对40份归类为“与可卡因相关死亡”的肾脏尸检标本进行了组织学检查；作为对照，检查了40名交通事故受害者的肾脏标本。半定量分析显示，玻璃样变性影响的肾小球数量与肾小球总数的比值在成瘾者中为0.09±0.13，在对照组中为0.005±0.01；差异非常显著。可卡因成瘾者的肾小球周围纤维化程度明显高于事故受害者。可卡因成瘾者的肾小球与肾小管铸型的比值为0.15±0.17，对照组为0.17±0.18（无显著差异）。成瘾者的间质细胞浸润程度明显高于对照组。单核细胞浸润主要出现在髓质区域。成瘾者的小动脉硬化明显高于对照组。对照组未出现中膜增厚、管腔狭窄和血管阻塞。对动脉结构的定量形态学分析显示，可卡因成瘾者的管腔周长、内膜周长、中膜周长、内膜面积、中膜面积、内膜厚度和中膜厚度均明显大于对照组。
