先兆子痫肾小球病病理观察与临床研究

目的 研究先兆子痫肾小球病病理改变及与临床的关系。方法对8例先兆子痫肾小球病患者的肾活检标本进行光镜、免疫荧光及电镜检查，观察病理特征并进行临床病理分析。结果病理改变：光镜以肾小球内皮细胞增生为特征，电镜表现更为显著，内皮细胞增生肿胀，上皮细胞足突大部融合，可表现节段性硬化。临床与病理联系：产后时间与内皮细胞增生肿胀程度呈负相关（r=-0．945，P〈0．01）。而尿蛋白量与上皮足突融合程度正相关（r=0．718，P〈0．05）。表现为节段硬化者，尿蛋白量较多，恢复较慢。结论内皮细胞损伤为本病病理特征，肾活检有助于诊断及病情轻重判断。

Pathological observation and clinical investigation on glomerulopathy in patients with preeclampsia

Objective To investigate the relationship between the pathological changes of glomerulopathy in patients with preeelampsia and clinical manifestations. Methods Renal biopsies in 8 patients with preeclampsia were observed by light microscopy, immunofluorescence and electron microscopy. The pathological changes were observed and analyzed. Results The examination by light microscopy showed that endothelial cells were swollen and bloodless due to hypertrophy of the intra-capillary cells. The examination by electron microscopy showed that there was hypertrophy of the cytoplasmic organelles in endothelial cells, and glomerular visceral epithelial cell foot-process was fused in greater parts, and focal glomerulosclerosis was found. According to clinical morphological analysis, the time after delivery was negatively correlated with the degree of endothelial lesion. （ r = -0.945, P 〈 0.01 ）. The amount of proteinuria was closely correlated with the degree of footprocess effacement （ r = 0. 718, P 〈 0. 05）. The cases with focal glomerulosclerosis had heavy proteinufia and recovered slowly. Conclusion Endothelial lesion is a significant feature of preeclampsia. Renal biopsy is the most valid diagnostic method.