老年及老年前期肾淀粉样变性和皮肤淀粉样变性临床研究

Clinical Study of Elder and Elder Early Renal Amyloidosis and Skin Amyloidosis

目的：研究老年及老年前期肾淀粉样变性及皮肤淀粉样变性的临床特点及病理分型。方法选取我院2010年6月～2011年6月收治的72例肾病综合征患者，对经肾穿刺确诊肾淀粉样变性16例患者进行光镜及免疫荧光检查，分析老年前期肾淀粉样变性及皮肤淀粉样变性的临床特点与病理分型。结果肾淀粉样变性可见血管、间质及肾小管壁呈块状沉积的淀粉样物质，KMnO4-碱性刚果红染色AL型15例， AA型1例；AL型显示免疫球蛋白轻链κ、λ沉积。结论肾淀粉样变性多见于中老年肾病综合征患者，临床表现无特异性，经肾活检光镜及免疫荧光检查可对疾病的病理学改变情况进行诊断。疑似肾淀粉样变性者应早期进行刚果红染色及肾活检，对特殊部位的皮肤淀粉样变引起注意，加强对疾病的准确判断，以免误诊影响疾病的治疗。

Objective To study the clinical characteristics and pathological types of renal amyloidosis and skin amyloidosis in elder patients. Methods Selected 72 cases of nephropathy integrated syndrome from June 2010 to June 2011 in our hospital, there were 16 cases with renal biopsy for diagnosis of renal amyloidosis, analyzed the clinical characteristics and pathological types of renal amyloidosis and skin amyloidosis in elder patients. Results Renal amyloidosis visible vessels, quality and the tubular wall was massive deposition of amyloid, 15 cases of KMnO 4 alkaline congo red staining AL type and1 case of AAtype, Al showed immunoglobulin protein light chain κ, λ deposition. Conclusion Renal amyloidosis occurs mainly in elderly nephrotic syndrome patients, the clinical manifestations without speciifc, after renal biopsy light microscopy and immunofluorescence examinations can be disease of pathological changes diagnosis. Suspected renal amyloidosis should be early by congo red staining and renal biopsy, also cause for the special parts of the skin starch like attention, strengthen the accurate judgment of the disease to avoid misdiagnosis inlfuence disease treatment.