环孢素A移植肾毒性损害的病理变化

目的：探讨环孢素A（CsA)移植肾毒性损害的病理特点，以指导临床应用。方法：对32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：25例有CsA肾毒性损害者中急性23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。结论：CsA对移植肾毒性损害的主要病理特点是肾小管上皮的空泡样变性的血管的玻璃样变。

Pathologic changes of nephrotoxicity with CsA in renal allografts

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.