CAJ | 학술논문

目的进一步了解类风湿关节炎(RA)肾损害的特点.方法对我科收治的20例RA合并肾损害患者的临床特点进行分析.结果以慢性肾炎表现者8例,肾病综合征(NS)表现4例,慢性间质性肾炎3例,慢性肾功能不全表现4例,急性肾功能不全1例;其中呈肾炎表现患者血免疫球蛋白升高,红细胞沉降率增快,多数患者C反应蛋白、类风湿因子升高,7例患者进行了肾活检,其中3例膜性肾病(MN),3例Iga肾病,1例并发血管炎.结论肾炎是RA肾损害的常见表现,而系膜增生性肾炎、膜性肾病是RA并发肾炎的常见病理类型;RA的基础病变之一为血管炎,可发生坏死性肾小球肾炎.免疫功能紊乱在RA并发肾损害中可能起重要的作用.
목적 진일보료해류풍습관절염(RA)신손해적특점.방법 대아과수치적20례RA합병신손해환자적림상특점진행분석.결과 이만성신염표현자8례,신병종합정(NS)표현4례,만성간질성신염3례,만성신공능불전표현4례,급성신공능불전1례;기중정신염표현환자혈면역구단백승고,홍세포침강솔증쾌,다수환자C반응단백、류풍습인자승고,7례환자진행료신활검,기중3례막성신병(MN),3례Iga신병,1례병발혈관염.결론 신염시RA신손해적상견표현,이계막증생성신염、막성신병시RA병발신염적상견병리류형;RA적기출병변지일위혈관염,가발생배사성신소구신염.면역공능문란재RA병발신손해중가능기중요적작용.
Objective To investigate the features of renal lesion in patients with rheumatoid arthritis (RA). Methods The clinical pathology changes of 20 patients with renal lesion by RA were analyzed. Results The clinical features of patients showed chronic glomerulonephritis in 8 cases,nephritic syndrome 4 cases, chronic interstitial nephritis in 3 cases, chronic renal failure in 4 cases, and acute renal failure in 1 case. The patients with glomerulonephritis accompanied with the increase of immunoglobulin, erythrocyte sedimentation rate, C-reactive protein or rheumatoid factor. Kidney biopsy of 7 patients found membranous nephro-pathy in, IgA nephropathy in 3 and vasculitis in 1. Conclusion The common renal lesion in RA is glomerulonephritis, with mesangial proliferative glomerulonephritis or membranous nephropathy. One of the basic pathoh,gi,.al changes is vasculitis,which could result in necrotizing vasculitis.The disorder of immunologic function couht play important role in renal damage in patients with RA.