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天啊!红斑狼疮肾脏居然也会出问题!快看看!

2018-8-13 19:58| 发布者: 王陈美| 查看: 4270| 评论: 138

简介:  红斑狼疮患者的肾脏一般都会增大,其表面光滑,有点状出血。光镜检査,有60%~70%患者肾脏有病变,而用电子显微镜和免疫荧光检査(包括活组织检査)98%以上肾脏均为异常。可先后损伤肾小球、肾小管、肾间质及血管等 ...
  红斑狼疮患者的肾脏一般都会增大,其表面光滑,有点状出血。光镜检査,有60%~70%患者肾脏有病变,而用电子显微镜和免疫荧光检査(包括活组织检査)98%以上肾脏均为异常。可先后损伤肾小球、肾小管、肾间质及血管等。


1肾小球

      肾小球病变纷歧。常见病变包含有基膜增厚、线圈样病变、类纤维病变、球丛细胞显着很多增生和坏死、通明物质栓塞、纤维上皮细胞半月体构成、肾小球毛细血管发作纤维蛋白变性或局灶性坏死(内有通明血栓以及苏木素小体),其间线圈样病变为SLE肾脏病变的特征性体现,它是因为免疫复合物的沉积使SLE患者肾脏安排中基膜增厚,局部有很多嗜酸性细胞滋润,相似曲折线圈,圈袢由内皮细胞和上皮细胞之间的类纤维物质组成。病变晚期,肾小球可与囊壁粘连,跟着纤维安排增多,肾小球可发作纤维化,纤锥安排通明变性呈玻璃样小体。

天啊!红斑狼疮肾脏居然也会出问题!快看看!61 作者: 来源:

2肾小管病变

      常见肾小管变性,肾小管细胞肿胀,而且经常有含有PAS糖原染色阳性颗粒,调集管可见到萎缩,并伴有核固缩,基底膜增厚及萎缩。肾小管可发作显著扩张,炎症损害严重者亦可见肾小管萎缩及坏死。免疫荧光检査可见70%的肾小管免疫荧光阳性。

天啊!红斑狼疮肾脏居然也会出问题!快看看!79 作者: 来源:

3肾间质病变

      肾间质的病变表现为间质水肿,并将肾小管彼此分隔,缓慢者可发现有散在性斑驳状散布的纤维化安排,病程越长纤维化则越显著,间质及纤维化安排中有淋巴细胞、浆细胞及安排细胞散在滋润。

天啊!红斑狼疮肾脏居然也会出问题!快看看!5 作者: 来源:

4血管病变

     SLE肾脏血管病变部位为小动脉,可呈坏死性动脉炎现象的类纤维化变性,伴轻度血管周围细胞滋润,这是本病特征性的血管壁硬化病变。如果呈现坏死性血管炎的病变者,首要损伤肾小动脉及部分叶间动脉,其特征为血管壁无细胞坏死,有蛋白栓子阻塞管腔,管壁很少或无白细胞滋润。

天啊!红斑狼疮肾脏居然也会出问题!快看看!38 作者: 来源:

5中枢神经系统病理变化

      中枢神经系统病理变化,主要是在大脑皮质,尤其是沟前区灰白质的血管易于遭到损害。体现有细小堵塞,血管壁部分坏死,多少不等的颅内出血;脊髓血管受损严重者可导致脊髓梗死。此外在脑部病变的血管内可见类纤维素性坏死和内膜增生性的变化,有内皮细胞增殖和淋巴细胞滋润,有弥漫性神经细胞削减,并可见到纤维蛋白栓塞和血管壁细胞的炎症性反应,可有广泛的细小血栓和局限性软化灶等。免疫荧光检査:在脑组织以及头绪膜丛能够见到免疫球蛋白IgG、IgM,补体Cs和免疫复合物冷静。脑脊液检査,可出现DNA-抗DNA复合物。
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