淀粉样变性肾病的病理诊断价值研究-第1篇.docx

? ? 淀粉样变性肾病的病理诊断价值研究 ? ? 肖军兰 [Summary]目的 探讨淀粉样变性肾病的病理诊断价值。方法 选取我院2011年1月～2016年1月收治的28例淀粉样变性肾病患者作为研究对象，回顾性分析其临床资料。结果 本研究28例患者中，6例为肾功能衰竭期，占21.43%；18例为肾病综合征期，占64.29%；4例为单纯蛋白尿期，占14.29%。高锰酸钾氧化刚果红染色结果显示，3例为AA型，25例为AL型。免疫荧光检测显示，可见免疫球蛋白及补体沉积，部分显示为阴性。不同临床分期患者的肌酐、尿素氮、24 h尿蛋白水平比较，差异有统计学意义（P0.05）。肾功能衰竭期和肾病综合征期患者的并发症发生率显著高于单纯蛋白尿期，差异有统计学意义（P [Key]淀粉样变性肾病；病理诊断；肾活检 [] R692.9 [] A [] 1674-4721（2016）11（a）-0007-04 [Abstract]Objective To explore the pathology diagnostic value of amyloidosis nephropathy.Methods 28 patients with amyloidosis nephropathy from January 2011 to January 2016 in our hospital were selected as study objects，and the clinical data of them were retrospectively analyzed.Results Among the 28 patients，6 cases were in renal failure stage and accounted for 21.43%；18 cases were in nephrotic syndrome and accounted for 64.29%；4 cases were in simple proteinuria and accounted for 14.29%.The result of potassium Permanganate oxidation Congo Red dye showed that 3 cases were AA type and 25 cases were AL type.From immunofluorescence assay，immunoglobulin and complement deposition were visible and some showed negative.The levels of creatinine，urea nitrogen，24 h urinary protein in different clinical stages were compared，and the differences were statistically significant （P0.05）.The incidence rate of complications in renal failure and nephrotic syndrome stage was higher than that in simple proteinuria，with significant difference （P0.05）.Conclusion Renal biopsy is the only effective method in the diagnosis of amyloidosis nephropathy，which is helpful to early diagnosis，early treatment and with higher clinical application value. [Key words]Amylaidosis nephropathy；Pathology diagnostic；Renal biopsy 淀粉樣变性病是一种比较常见的系统性疾病，临床特点为特殊蛋白沉积，容易累及多种脏器，包括胃肠道、肝脏、心脏以及肾脏等[1]，其中肾脏是一种比较常见的受累器官。由于肾脏沉积大量的淀粉样蛋白，其导致的肾脏疾病被诊断为淀粉样变性肾病，在住院患者中具有较高的发病率，为0.09%～8.00%[2-3]。淀粉样物作为无定形的一种玻璃样透明物质，含有多种蛋白如Bz微球蛋白、肽类蛋白、前白蛋白、AA蛋白以及含AL蛋白等。淀粉样变性肾病具有病程长、并发症多等特点，如果治疗不及时，容易出现心律失常、心力衰竭以及消化道出血等一系列并发症，不仅危害患者健康，在严重情况下甚至危及患者的生命安全。一般来说，