[Objective]To understand the relationship between the pathological change of kidney and clinicai manifestations in hypertensive nephropathy patients.[Methods]The changes of blood pressure, eyeground, urine and renal function in patients with hypertensive nephropathy treated in nephrology department of our hospital in recent 2 years were analyzed.B-mode ultrasound guided renal puncture biopsy with 16G ejection needle was performed for 47 cases.The specimens were examined by light microscope and immunofluorescence.[Results]The pathological changes in patients with hypertensive nephropathy were varied.The major manifestations were benign arteriolar nephrosclerosis, hyaline degeneration of renal arterioles and the wall thickening.Severe cases showed malignant arteriolar nephrosclerosis, fibrinoid necrosis of renal arterioles, intimal hyperplasia and typical onion-like changes.With the increasing of the course of hypertension, renal artery and lesion were aggravated.[Conclusion]The pathological change of hypertensive nephropathy is associated with the clinical course of the disease.Renal pathological examination has important significance for the guidance of treatment and the judgement of the prognosis.%[目的]了解高血压肾病患者肾脏病理改变与临床表现的关系.[方法]分析本院肾内科近2年收治的高血压肾病患者的血压、眼底、尿和肾功能变化,对其中47例采用16G弹射针在B超引导行肾脏穿刺活检,标本分别进行光镜、免疫荧光检查.[结果]高血压肾病患者的病理改变表现多样,多数表现为良性小动脉性肾硬化症:肾小动脉玻璃样变,管壁增厚.病情严重者表现为恶性小动脉肾硬化症:肾小动脉纤维素样坏死、内膜重度增生,呈现典型的洋葱样改变.随着高血压病程增加,肾动脉及肾脏病损害加重(P<0.05).[结论]高血压肾病患者其病理改变与临床病程有关,行肾脏病理检查对指导治疗和判断预后有非常重要意义.
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