过度训练致急性肾损伤患者的肾脏病理分析

Analysis of the renal histopathological changes on the human of overtraining induced acute renal injury

目的探讨过度训练致急性肾损伤患者的肾脏病理情况。方法回顾性分析我院近年收治的过度训练后出现急性肾损伤并行肾活检8例患者的临床及病理资料，包括一般情况、实验室检查及病理结果。结果8例患者在过度训练后出现急性肾损伤，表现为尿潜血阳性2例，尿蛋白阳性3例，尿潜血、尿蛋白均阳性3例。肾功能异常5例，表现为肌酐、尿素氮、尿酸明显升高；肾脏超声无特异性变化，表现为皮质区回声增强。肾脏病理2例。肾小球有缺血性表现；2例肾间质存在轻度水肿，5例炎性细胞浸润；3例肾小管上皮空泡变性，2例肾小管萎缩，4例肾小管上皮刷状缘脱落，管腔内见蛋白管型，1例钙沉积。结论过度训练可引起肾脏损伤，肾脏病理以缺血性改变为主，其中以对缺血最敏感的肾小管为主，另外过度训练还可诱发炎症反应及横纹肌损伤。

Objective To investigate the renal histopathological changes of over training induced acute renal injury in human beings. Methods Eight patients treated in our hospital admitted overtraining were observed retrospectively about their clinical and pathological data, including clinical features, laboratory tests and pathological examinations. Results Eight patients with acute kidney injury after overtraining, manifested as urine occult blood positive in 2 cases, 3 cases of urinary protein, urinary occult blood and urine protein were positive in 3 cases. Five cases of renal dysfunction, manifested as creatinine,urea nitrogen, uric acid significantly increased; renal ultrasound non-specific changes, manifested as increased echogenieity of the cortex. 2 cases of renal pathology glomendar ischemic; Two cases of renal interstitial mild edema, five cases of inflammatory cell infiltration; Three cases of renal tubular epithelial vacuolar degeneration, 2 cases of tubular atrophy,4 cases of renal tubular epithelial brush border loss, see intraluminal protein casts can be seen, 1 case of calcium deposition. Conclusion The acute renal injury can be induced by overtraining. Kidney pathology ischemic is the most important change and renal tubular show most sensitive features of isehemic. In addition, inflammatory response and striated muscle damage were also induced because of overtraining.