狼疮足细胞病:一种特殊类型的狼疮性肾炎

发布时间：2018-02-15 23:30

本文关键词： 狼疮性肾炎狼疮足细胞病病理分型　出处：《肾脏病与透析肾移植杂志》2017年01期 　论文类型：期刊论文

【摘要】：系统性红斑狼疮患者临床表现为肾病综合征,肾活检病理表现为肾小球轻微病变(MCD)、系膜增生(Ms P)或局灶节段性肾小球硬化(FSGS),超微结构以足细胞足突广泛融合为特征,毛细血管袢内皮下及上皮侧无免疫沉积物的肾损害称为狼疮足细胞病。肾小球病理改变为MCD和Ms P的狼疮足细胞病患者,血尿发生率低,激素治疗敏感,但单用激素维持的复发率高达90%,激素联合其他免疫抑制剂维持可显著降低复发率。而病理表现为FSGS的狼疮足细胞病患者,急性肾损伤的发生率高,肾小管间质损伤重,激素治疗缓解率低。狼疮足细胞病复发后可发生病理转型,远期预后良好。狼疮足细胞病应作为一类特殊类型狼疮性肾炎纳入新的病理分型体系中。
[Abstract]:The clinical manifestations of patients with systemic lupus erythematosus were nephrotic syndrome. The pathological features of renal biopsy were mild glomerular lesion (MCDT), Mesangial hyperplasia (Ms P) or focal segmental glomerulosclerosis (FSGSN). The ultrastructure was characterized by extensive fusion of podocyte foot process. The renal damage without immune deposit in the capillary loop is called lupus podocytosis. The glomerular pathological changes are lupus podocytosis with MCD and Ms P. The incidence of hematuria is low and the hormone therapy is sensitive. However, the recurrent rate of hormone maintenance was as high as 90%. The recurrence rate was significantly decreased by hormone combined with other immunosuppressive agents. The incidence of acute renal injury was high and the renal tubulointerstitial injury was serious in patients with lupus podocytosis (FSGS). The remission rate of hormone therapy is low. Lupus podocyte can undergo pathological transformation after relapse and has a good long-term prognosis. Lupus podocyte should be included as a special type of lupus nephritis in the new pathological classification system.
【作者单位】：南京军区南京总医院肾脏科国家肾脏疾病临床医学研究中心全军肾脏病研究所;
【基金】：国家自然科学基金(81470042)
【分类号】：R593.242

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