肾淀粉样变性的临床、病理及免疫病理

The clinical,pathological and immunopathological features of renal amyloidosis

分析８例肾淀粉样变性的临床、病理及免疫病理特点，并在国内首次川肾组织免疫球蛋白ｋ，λ轻链、血清淀粉Ａ蛋白（ＳＡＡ）染色及高锰酸钾试验辅助分型。结果显示；①淀粉样变性多见于５０岁以上患者，常表现为多系统损害伴有典型肾病综合征；②肾脏病理改变以“肾小球系膜区结节状硬化和非增殖、非炎症性变化”为特征。免疫病理常呈多种免疫球蛋白、补体共同沉积的“满堂红”现象；③７例ＡＬ型与１例ＡＡ型淀粉样变的肾脏病理改变类似，但前者有ｋ、λ轻链的沉积，后者可检出ＳＡＡ。高锰酸钾试验阴性３例均为ＡＬ型，阳性１例为ＡＡ型。

he clinical,pathological and immunopathological features were investigated in 8 patients with renal amyloidosis proved by renal biopsy,and immunoglobine light-chains,serum A protein (SAA) as well as potassium permangante test in renal tissue were carried out in order to classify renal amyloidosis.The results showed that its clinical manifestations were various,and renal biopsy must be done when amyloidosis was suspected.Immunoglobine light-chains ,SAA and potassium permangante test were much useful in the classification of renal amyloidosis.