29例女性干燥综合征的肾脏损害分析

Clinical and pathological analysis of 29 cases Signer's syndrome renal injury in famale

目的 结合肾活检及近期检测进展 ,了解女性干燥综合征(siogren'ssyndrome,ss)肾脏损害。 方法 对本科1992年～2000年间收住的29例女性SS患者 ,进行常规、免疫学、肾小管功能、小唇腺(下唇小涎腺)活检及肾活检等检查。结果 29例SS中有25例伴有肾脏损害 ,17/25例主要表现为肾小管功能受损(14/17例为I型肾小管酸中毒(RTA) ,1/17例为II型RTA ,2/17例表现为尿 β2微球蛋白、RBP、NAG升高)。6/25例有肾小球病变(2/6例表现为肾病综合征 ,4/6例为肾小球肾炎)。2/25例表现为肾功能不全。肾脏活检病理光镜 :14/15例有肾小管间质病变 ,免疫荧光8/15例阴性 ,部分标本有免疫球蛋白和补体小球沉积。24例应用强的松治疗 ,10例用枸椽酸合剂 ,4例加用霉酚酸酯 (骁悉 )。结论 SS肾脏损害常见 ,以dRTA和肾小球肾炎为主要表现 ,强的松治疗可减少间质淋巴浆细胞浸润 ,改善肾功能 ,用枸椽酸合剂纠正RTA。

Objective To enhance the understanding of the clinical features --renal injury of sjogren's syndrome combining with renal biopsy. Methods Clinical、laboratory、immunity and renal biopsy were made in 29 cases sjogren's syndrome from 1992 to 2000 in our department. Results 25 patients (25/29) of SS with renal injury. 14 of the 25 cases presented with type Ⅰrenal tubular acidosis(RTA);1 of the 25 cases presented with typeⅡRTA;2 of the 25 cases presented with Nephritic syndrome,4 of the 25 cases presented with glomerulonephritis.in 15 renal biopsy specimens, 14 cases showed chronic interstitial nephritis with Ig and C3 sedimentation. Conclusion Renal injury may be the presenting or predominant feature the major clinical manifestations are RTA .treatment with prednisone is safe and highly effective