高原红细胞增多症与肾损害关系研究  

Study on the Relationship Between Altitude Erythrocytosis and Renal Damage

作　　者：巴应贵[1] 张瑞霞[1] 秦凤[1] 辛宏云[1] 谢小元[1] 孙昊[1] 

机构地区：[1]青海大学附属医院肾病科,810001

出　　处：《高原医学杂志》2017年第1期15-18,共4页Journal of High Altitude Medicine

摘　　要：目的:研究高原红细胞增多症与肾损害关系。方法:对明确诊断高原红细胞增多症合并蛋白尿患者行肾素血管紧张素Ⅰ(A1,卧位)、肾素血管紧张素Ⅱ(A2,卧位)、血浆肾素活性(PRA,卧位)及醛固酮(ALD)水平的观察并结合肾活检病理诊断进行分析研究。结果:高原红细胞增多症合并蛋白尿组与原发性慢性肾炎组、体检健康人群组比较时,其A1、A2、PRA及ALD水平均高于原发性慢性肾炎组、体检健康人群组,尤以血浆肾素活性水平升高为主。肾活检病理诊断(南京军区福州总医院肾脏病理诊断:高原红细胞增多症肾损害):(1)系膜轻-中度增生,毛细血管内红细胞淤积或瘀血,局灶节段硬化,局灶球形肾小球硬化;(2)轻度肾小管萎缩及间质纤维化;(3)动脉硬化(1~2)分。结论:高原红细胞增多症时可引起肾脏组织病变及出现临床症状,即高原红细胞增多症肾损害。Objective： The study investigates the relationship between altitude erythrocytosis and renal damage.Method：The patients who were clearly diagnosed of altitude erythrocytosis histiocytosis associated with proteinuria were treated with renin vascular tension I （A1）, renin vascular tension angiotensin Ⅱ （A2）, plasma renin activity （PRA）, observed their aldosterone （ALD） levels and analyzed their renal biopsy pathological diagnosis. Results： Compared with primary chronic nephritis group and healthy people group, the plasma A1, A2, PRA （supine） and ALD levels of altitude erythrocytosis combined albuminuria group were higher. In particular, the PRA （horizontal） level is mainly increased. Renal biopsy pathological diagnosis：（1） light to moderate hyperplasia of mesangial; sedimentation or blood stasis of red blood cells in capillary; focal segmental sclerosis; focal spherical glomerular sclerosis;（2）mild renal tubular atrophy and interstitial fibrosis; （3）arteriosclerosis about 1- 2.Conclusion： Altitude erythrocytosis can cause kidney disease and the clinical symptom, that is, high altitude polycythemia kidney damage.

关 键 词：高原红细胞增多症 肾损害 关系 研究 

分 类 号：R594.3[医药卫生—内科学]