继发性肾淀粉样变的发病机制与治疗

The pathogenesis and treatment of secondary renal amyloidosis

继发于慢性炎性疾病等多种疾患的淀粉样变常累及肾脏 ,表现为大量蛋白尿 ,并可引起肾病综合征甚至肾功能衰竭。淀粉沉积物中的淀粉样A纤维以及淀粉样物促进因子、淀粉样P物质、载脂蛋白E、硫酸肝素蛋白多糖等成份参与了疾病的发生与发展。目前关于该疾患的药物治疗 ,如细胞毒类制剂、秋水仙碱、二甲亚砜的实验和临床研究日趋成熟 。

Amyloidosis secondary to chronic inflammatory diseases and other illnesses often involve kidney.The most common presentation is non selective and massive proteinuria,nephrotic syndrome even renal failure.Studies show that amyloid A fibril,amyloid enhancing factor,amyloid P component,apolipoprotein E and heparan sulfate proteoglycans may take part in the occurrence and development of the disease.At present the experimental and clinical researches about the medical treatment of renal amyloidosis, such as cytotoxic drugs,colchicine,dimethyl sulfoxide,become more and more matured.And the experiences about renal replacement therapy become richer and richer.