系统性硬皮病的肾脏损害

Renal lesion in systemic scleroderma

目的 :研究系统性硬皮病 (SSc)的肾脏损害、肾危象的发生、临床表现及可能的发病原因。方法 :对 10 5例SSc临床及实验室资料作回顾性分析。对 4例SSc用冷水激发雷诺现象后观察肾皮质血流情况。结果 :10 5例SSc中 2 5例有肾损害 ,其中 3例发生肾危象。冷水激发后肾皮质血流减少。结论 :SSc肾脏损害发生率为 2 4% ,严重者短期内可引起死亡。

Objective :To understand the occurrence of the clinical manifestations and possible pathogenesis of the renal lesions and renal crisis in systemic scleroderma(SSc). Methods:The clinical and laboratory data of 105 cases with SSc in this hospital were analyzed. We examined the renal cortical blood flow in 4 cases with Raynauds phenomenon by colour Doppler echography while Raynauds phenomenon appeared on the hands after stimulating with 4℃ water. Results: There were 25 cases with renal lesion in 105 cases with SSc. Three cases died of renal crisis(3%). Conclusion:The incidence of renal lesions in SSc was 24%. The severe cases may die in short duration. After the cold water test, the blood flow rate of the renal cortex slowed down, and the blood flow volume decreased. The possible pathogenesis of renal crisis is the renal vascular lesions due to autoimmunity and renal vasospasm as Raynauds phenomenon appearing on the hands.