肾脏功能减退与肾血管病变的相关性研究

目的探讨肾脏功能减退与肾血管病变的关系。方法回顾性分析132例肾活检患者的临床资料。以MDRD简化公式评估肾小球滤过率(GFR),并将患者分为四组,A组:对照组;B组:血压正常,GFR>90mL/min;C组:血压正常,GFR30～90mL/min;D组:高血压,GFR30～90mL/min。将四组患者的肾活检组织进行光镜、电镜和免疫荧光检查,观察肾血管病变情况。结果与A组相比,B组患者血管病变无明显增加(6.7%vs.11.1%);C组血管病变程度(34.3%)较B组明显加重(P<0.05);D组血管病变程度在各组中最为严重(45.0%),但与C组比较无显著差异(P>0.05))。结论随着肾小球滤过率的下降,即使无高血压的存在,血管病变也逐渐增加。肾脏血管病变可一定程度上反映患者肾脏功能减退的情况。

Relationship Between Decreased Renal Function and Renal Vascular Changes

Objective To study the relationship between decreased renal function and renal vascular changes. Methods We retrospectively selected 132 patients who had accepted renal biopsy and calculated the glomerular filtration rate (GFR) by MDRD simplified formula. The biopsies were divided into four groups: group A, normotensive controls; group B, normotensive patients with GFR >90 mL/min; group C,normotensive patients with GFR 30~90 mL/min; group D, hypertensive patients with GFR 30~90 mL/min. Results In contrast to control subjects no significant changes were seen in group B (6.7% vs. 11.1%) (P>0.05). Renal vascular changes were observed when renal function declined in group C(34.3%)(P<0.05). The vascular changes were aggravated in patients with renal insufficiency and hypertension in group D (45.0%) (P<0.05). Conclusion The loss of renal function is accompanied by vascular changes, even in the absence of systemic hypertension.