肾实质性恶性高血压患者16例临床及肾脏病理分析

目的:探讨肾实质性恶性高血压的临床及肾脏病理特点。方法:回顾分析16例肾实质性恶性高血压患者的临床及病理资料。结果:16例肾实质性恶性高血压中,临床诊断为肾病综合征4例(25%),慢性肾小球肾炎8例(50%),硬皮病肾危象1例(6.25%),间质性肾炎1例(6.25%),狼疮性肾炎2例(12.5%)。16例患者均表现为进行性肾功能损害;临床表现以蛋白尿为主,其次为蛋白尿伴血尿。肾脏病理改变以肾小球病变为主者15例(93.75%),肾小管间质疾病1例(6.25%)。结论:肾实质性恶性高血压患者年龄较轻,主要表现为肾功能进行性恶化,肾脏结构多数异常;肾脏病理改变以增生硬化性肾小球病变为主。肾实质性恶性高血压患者疗效较差,预后不好。

Clinical and nephrotic pathology features in renal malignant hypertension: Analysis of 16 cases

Objective： To explore both the clinical and renal pathological features of renal malignant hypertension （RMHP）. Methods ： The data were reviewed in 16 cases with RMHP with regard to the clinical symptoms and pathological findings. Results： Of the 16 patients with RMHP （mean age, 38 years）, 4 were confirmed nephritic syndrome（ 25% ） ; 8, chronic giomerulonephritis （ 50% ） ; 1, sclerederma renal crisis （6.25%） ; 1, interstitial nephritis （ 6.25% ） and 2, lupus nephritis （ 12.5% ）. The total 16 cases were characterized by progressive renal insufficiency with dominant albuminuria or presence of blood in the urine. Glomerulopathy was registered as significant pathological change in 15 casas（93.75% ） and another 1, tubulointerstitial nephropathy （6.25% ）. Conclusion： Patients with RMHP tend to be younger age currently. The disease is consistent with progressive renal insufficiency, with major abnormal kidney structure. The pathological change is characterized by hyperplastic sclerosing glomerulopathy, and undesirable therapeutic effect often leads to poor outcome.