慢性燃煤砷污染所致肾损害的临床病理观察

The clinically pathologic investigation of renal function impairment by aresnism caused by coal-burning pollution

目的 探讨慢性燃煤型砷污染对肾脏功能损害的临床病理学特征。方法 对 10 8例慢性砷中毒患者进行血、尿β2 -微球蛋白及肌酐、尿素氮检测 ,并对其中 5例患者进行肾脏病理学检查。结果 慢性燃煤污染型砷中毒组血肌酐、尿素氮与对照组比较差异无显著意义 (P>0 .0 5) ,而血、尿 β2 -微球蛋白 2组差异有显著意义(P <0 .0 1) ;病理学检查显示肾小球体积增大 ,毛细血管内皮细胞肿胀 ,肾间质水肿 ,系膜细胞增生 ,有少许炎性细胞浸润 ,近曲小管中度肿胀变性及脂肪变性。结论 燃用高砷煤所致砷污染可造成肾小球、肾小管功能病理性损害 ;血、尿β2

Objective To research the clinically patholog ical characters of renal function impairment by coal-burning aresnism.Methods The levels of β 2-microglobulin, creatinine and Urea nitrogen in Blood and urine samples from 108 aresnism patients were det ected,and the pathological examination of kidney was made in 5 patients.Results The creatinine and urea nitrogen levels of ares nism patients were similar to those of the control group (P>0.05), but in β 2-microglobulin level was significantly different between the aresnism patien ts and the control (P<0.01).The pathologic observation showed renal glomerul i enlargement, blood capillary endothelial cells swelling, stroma edema, basal lamina cells proliferation, proximal convoluted tubule swelling and fatty degen eration. Conclusions The aresnism by coal-burning pollution can cause the pathologic lesions of renal corpuscle and tubule. β 2-microglobuli n in blood and urine is a sensitive marker to detect early-stage renal damage caused by arsenic.