环孢素A移植肾毒性损害的病理变化

Pathologic changes of nephrotoxicity with CsA in renal allografts

目的 探讨环孢素A(CsA)移植肾毒性损害的病理特点 ,以指导临床用药。 方法 对3 2例移植肾进行病理取材 ,HE染色 ,光镜下观察移植肾组织病理变化。 结果 2 5例有CsA肾毒性损害者中急性 2 3例 ,主要病理变化为肾小管上皮空泡样变性 ;慢性 2例 ,病理变化为血管及间质的玻璃样和粘液样变。

Objective To study the pathologic changes of nephrotoxicity with CsA and to give advice on clinic drug administration. Methods Thirty two cases of renal allografts were biopsied.Histological changes of the biopsy specimens were examined by light microscopy. Results Twenty five cases of the 32 cases were identified having CsA nephrotoxicity.Of them 23 demonstrated acute nephrotoxicity.The main pathologic changes were vacuole's degenerations of glomerular tubular epithelial cells.The other 2 had chronic nephrotoxicity,and were histologically characterized by striped tubular interstitial fibrosis and hyalinization of the afferent arteriole. Conclusions Major histopathologic changes of CsA nephrotoxicity are tubular vaculation and vessel hyalinization,which are the main indicators for detection of CsA nephrotoxicity.