系统性硬化症患者肾脏临床病理学研究

PRELIMINARY PATHOLOGICAL STUDIES OF RENAL DISORDERS IN THE PATIENTS WITH SYSTEMIC SCLEROSIS

目的：了解系统性硬化症病人肾脏病理改变。方法：首次对５例ＳＳｃ患者进行了肾脏活检和尸检标本的组织学观察。结果：发现４例标本显示有不同程度的小叶间动脉和弓动脉、入球小动脉的受累，其中２例临床无肾脏受累表现，此４例患者病程相近。值得一提的是病程长达２２年的老年患者其肾脏病理主要为慢性肾小球肾炎。结论：提示患者的肾脏血管改变可能影响其病程。

Objective:To assess the renal pathological changes in patients with systemic sclerosis (SSc).Methods:Histological studies were performed in 5 SSc patients (renal biopsy 4 and autopsy 1).Results:The vascular changes such as intimal proliferation of interlobular arteries were observed in 4 patients with 2～3 year disease duration,two of them had no clinical manifestation.One patient who had 22 year duration without clinical manifestation showed glomerular abnormality and the vascular change was minor.Conclusion:The degree of the vascular involvement may be closely associated with the progress of SSc and more works need to be done to prove it further,the vascular changes could be observed in the SSc patients without clinical features of renal involvement.