摘要
为探讨原发性干燥综合征（ＳＳ）肾损害的临床及病理特征，对２６例住院原发性ＳＳ合并肾损害行肾活检病人的临床及病理表现进行了总结。结果显示：其肾损害的主要表现为肾小管酸中毒２０例、蛋白尿２１例及肾功能不全５例；２４例肾活检免疫病理示ＩｇＧ９例、ＩｇＡ８例、ＩｇＭ７例及Ｃ３１０例肾小球基底膜及系膜区沉积；病理表现为慢性间质性肾炎（ＩＮ）１０例，ＩＮ合并局灶节段增殖性肾小球肾炎４例、硬化性肾小球肾炎４例，弥漫系膜增殖性肾炎和膜增殖性肾炎各１例及膜性肾炎４例。该结果提示：原发性ＳＳ肾损害时，肾小球内免疫复合物沉积及肾小球肾炎并不少见，不容忽视。
Previous study suggested that renal involvement in primary sjgren′s syndrome (SS) was rare and renal damage in SS cases has not been reported in Chinese literature. In this study the clinical and pathological features in 26 primary SS patients (23 female and 3 male, with an average age of 40.9 years) were analyzed. The spectrum of renal disorders in these patients was as follows: renal tubular acidosis (20/26) , hypokelemia (18/26), hypocalcemia (14/26), mild proteinuria (less than 1.5g/d, 12/26), massive proteinuria (more than 1.5g/d, 9/26, including 5 nephrotic syndrome), and renal insufficiency (5/26). Light microscopy (LM) might show acute or chronic interstitial nephritis (IN, 10/26), or IN accompanied with focal glomerulonephritis (FGN, 4/26), focal segmental glomerulosclerosis (FSGS, 4/26), membranous nephropathy (MN, 3/26), diffuse mesangial proliferative glomerulonephritis (MePGN, 1/26) and membranoproliferative glomerunephritis (MPGN, 1/26) in these SS patients. A variable degree of interstitial lesion was also noted in all patients with glomerular damage. Immunofluorescent examination revealed deposits of IgG (9/24), IgA(8/24), IgM(7/24), C3(10/24) and C1q(2/24) in granular distribution on the glomerular basement membrane (GBM) or focal masangium and focal deposits of IgG and C3(7/24) on the tubular basement membrane (TBM). These results suggested that renal tubular acidosis is the most common finding in Chinese SS patients with renal involvement, but glomerular damage is not uncommon. Although IN was the major pathological manifestation in SS patients, FGN, FSGS, MN, MePGN and MPGN might also be found. The exact incidence of secondary glomerular disease in primary SS needs to be studied further.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1997年第1期28-31,共4页
Chinese Journal of Internal Medicine
关键词
干燥综合征
肾损害
病理分析
Sjogren′s syndrome Nephritis, intestitial Biopsy
