系统性硬化症并肾功能不全患者的临床分析  

Clinical Analysis of Patients with Systemic Sclerosis Complicated with Renal Insufficiency

作　　者：许雪莲[1] 孙荧 宫笑微[1] 李荣滨[1] 宋丽萍[1] 刘微[1] 田微 刘莎[1] XU Xue-lian;SUN Ying;GONG Xiao-wei;LI Rong-bin;SONG Li-ping;LIU Wei;TIAN Wei;LIU Sha(Department of Rheumatology and Immunology,Qiqihar First Hospital,Qiqihar,Heilongjiang Province,161000 China)

机构地区：[1]齐齐哈尔市第一医院风湿免疫科

出　　处：《中外医疗》2019年第32期7-9,共3页China & Foreign Medical Treatment

基　　金：黑龙江省卫生计生委科研课题：系统性硬化症合并肾功能不全的临床研究(编号：2017—291)

摘　　要：目的了解系统性硬化症并肾功能不全患者的临床表现及病理特点。方法对2002年1月—2017年3月齐齐哈尔第一医院风湿科病房和门诊收治的36例临床确诊的系统性硬化症并肾功能不全患者进行回顾性临床分析,并对其中11例患者进行了肾组织病理学检查。结果在36例系统性硬化症合并肾功能不全患者中,临床表现为肾危象(SRC)16例,慢性肾损伤和炎症性肾损害为13例,重叠结缔组织病为3例,药物相关为3例,其他1例。11例患者肾组织学显示系统性硬化肾功能不全肾脏血管改变为多样性,其中6例肾活检示小叶间动脉和入球小动脉内皮细胞增生、肿胀、内膜粘液性水肿,肾病,另2例表现为药物因素。结论系统性硬化症肾功能不全可能由疾病本身、重叠疾病、药物等因素所致。疾病本身所致的肾损害可表现为肾危象、炎性改变或慢性损害。系统性硬化症肾功能不全原因不清时可行肾脏活检检查,以帮助临床治疗及判断预后。Objective To understand the clinical manifestations and pathological features of patients with systemic sclerosis complicated with renal insufficiency.Methods A retrospective clinical analysis was performed on 36 patients with clinically confirmed systemic sclerosis and renal insufficiency admitted from January 2002 to March 2017,qiqihar first hospital rheumatology ward and outpatient department.Renal histopathology was performed in 11 of them.Results Among 36 patients with systemic sclerosis complicated with renal insufficiency,the clinical manifestations were 16 cases of renal crisis(SRC),13 cases of chronic kidney injury and inflammatory renal damage,and 3 cases of overlapping connective tissue disease.3 cases of drug-related,the other 1 case.Renal histology of 11 patients showed systemic sclerosing renal dysfunction and renal vascular changes were diverse,of which 6 renal biopsy showed interlobular artery and afferent arteriolar endothelial cell hyperplasia,swelling,intimal mucinous edema,nephropathy,and 2 case were manifested as a drug factor.Conclusion Systemic sclerosis may be caused by the disease itself,overlapping diseases,drugs and other factors.Kidney damage caused by the disease itself can manifest as a kidney crisis,an inflammatory change or a chronic damage.Systemic sclerosis Renal dysfunction is unclear when a renal biopsy is available to help with clinical treatment and prognosis.

关 键 词：硬皮病 系统性 肾功能不全 

分 类 号：R322.61[医药卫生—人体解剖和组织胚胎学]