老年及老年前期肾小球疾病患者肾小管间质损害的临床与病理

Clinical and pathological studies on the tubulointerstitial lesions in the aged and preaged patients with glomerular disease

了解高龄原发性肾小球疾病患者肾小管间质损害的特点，探讨其临床意义。方法对８２例老年及老年前期原发性肾小球疾病患者的肾组织学类型及小管间质形态学改变、肾小管功能、肾功能和蛋白尿作了观察与分析。结果本组肾小管功能不全和小管间质形态学异常的发生率均高，且两者之间存在密切关系。多项肾小管功能检测指标的异常与小管间质损害程度呈显著正相关。小管间质损害亦与肾组织学类型、肾功能和尿蛋白量有关。结论监测高龄肾小球疾病患者的肾小管功能，对有条件者行肾活检，对于早期发现和治疗肾小管间质病变，延缓肾功能不全的发生具有重要的临床意义。

Objective To identify the characteristics of tubulointerstitial lesions in the elderly patients with primary glomerular disease and to approach their clinical significance.Methods The histological type and morphological changes in tubulointerstitial lesions,the renal function,the tubular function as well as proteinuria were analysed in aged and preaged patients with glomerular disease.Results A high incidence of tubular disfunction and morphological abnormality in tubulointerstitial mesenchyma were observed in these cases. There was a close relationship between them. The abnormalities of several tubular function indices positively correlated with the degree of tubulointerstitial lesions. The tubulointerstitial lesions were also corelated with the type of histopathology,the renal function and the quantity of proteinuria . Conclusions The determination of tubular function and the performance of renal biopsy,if possible have a important clinical significance for early diagnosis and treatment of tubulointerstitial lesions and delaying the occurence of renal failure.