本文關(guān)鍵詞： 狼瘡性腎炎 狼瘡足細胞病 病理分型　出處：《腎臟病與透析腎移植雜志》2017年01期 　論文類型：期刊論文

【摘要】：系統(tǒng)性紅斑狼瘡患者臨床表現(xiàn)為腎病綜合征,腎活檢病理表現(xiàn)為腎小球輕微病變(MCD)、系膜增生(Ms P)或局灶節(jié)段性腎小球硬化(FSGS),超微結(jié)構(gòu)以足細胞足突廣泛融合為特征,毛細血管袢內(nèi)皮下及上皮側(cè)無免疫沉積物的腎損害稱為狼瘡足細胞病。腎小球病理改變?yōu)镸CD和Ms P的狼瘡足細胞病患者,血尿發(fā)生率低,激素治療敏感,但單用激素維持的復發(fā)率高達90%,激素聯(lián)合其他免疫抑制劑維持可顯著降低復發(fā)率。而病理表現(xiàn)為FSGS的狼瘡足細胞病患者,急性腎損傷的發(fā)生率高,腎小管間質(zhì)損傷重,激素治療緩解率低。狼瘡足細胞病復發(fā)后可發(fā)生病理轉(zhuǎn)型,遠期預后良好。狼瘡足細胞病應作為一類特殊類型狼瘡性腎炎納入新的病理分型體系中。
[Abstract]:The clinical manifestations of patients with systemic lupus erythematosus were nephrotic syndrome. The pathological features of renal biopsy were mild glomerular lesion (MCDT), Mesangial hyperplasia (Ms P) or focal segmental glomerulosclerosis (FSGSN). The ultrastructure was characterized by extensive fusion of podocyte foot process. The renal damage without immune deposit in the capillary loop is called lupus podocytosis. The glomerular pathological changes are lupus podocytosis with MCD and Ms P. The incidence of hematuria is low and the hormone therapy is sensitive. However, the recurrent rate of hormone maintenance was as high as 90%. The recurrence rate was significantly decreased by hormone combined with other immunosuppressive agents. The incidence of acute renal injury was high and the renal tubulointerstitial injury was serious in patients with lupus podocytosis (FSGS). The remission rate of hormone therapy is low. Lupus podocyte can undergo pathological transformation after relapse and has a good long-term prognosis. Lupus podocyte should be included as a special type of lupus nephritis in the new pathological classification system.
【作者單位】： 南京軍區(qū)南京總醫(yī)院腎臟科國家腎臟疾病臨床醫(yī)學研究中心全軍腎臟病研究所;
【基金】：國家自然科學基金(81470042)
【分類號】：R593.242

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