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首页> 外文期刊>South African medical journal: Suid-Afrikaanse tydskrif vir geneeskunde >Focal segmental glomerulosclerosis in malignant hypertension.
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Focal segmental glomerulosclerosis in malignant hypertension.

机译：恶性高血压的局部节段性肾小球硬化症。

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OBJECTIVE: Focal segmental glomerulosclerosis (FSG) may occur in primary malignant hypertension (MHT) either as a result of glomerular hyperfiltration or fibrinoid necrosis (FN), and may contribute to renal dysfunction. To determine the frequency of occurrence and distribution of FSG in primary MHT we studied renal biopsy specimens from 38 black Africans--30 postmortem and 8 needle-biopsy specimens. SUBJECTS: There were 31 male subjects and 7 female, with a mean age of 46 (+/- 7) years. RESULTS: Mean blood pressure (BP) was 206 +/- 15/137 +/- 9 mmHg, median 24-hour proteinuria (interquartile (IQ) range) was 5.1 g (3.3-6.5 g), median serum albumin 3.4 g (3.2-3.8 g) and median serum creatinine 540 mumol/l (425-752 mumol/l). Mucoid intimal proliferation was present in all the sections but FN was seen in 29 (76%). Glomerulosclerosis was present in all the sections, and was axially distributed in 7 (18%), segmentally in 22 (58%), and globally in 9 (24%). Median 24-hour proteinuria was 2.8 g (0.8-3.5 g IQ range), 5.6 g (1.7-8.1 g) and 3.4 g (2.6-4.0 g) respectively, and corresponding values of serum creatinine were 770 mumol/l (106-1,274 mumol/l IQ range), 522 mumol/l (248-991 mumol/l) and 1,230 mumol/l (920-1,558 mumol/l) respectively. CONCLUSION: The distribution of glomerulosclerosis did not appear to relate to proteinuria or serum creatinine, although cases with segmentally distributed glomerulosclerosis appeared to have the highest proteinuria, and those with global glomerulosclerosis appeared to have the highest serum creatinine levels. FSG therefore occurs prominently in primary MHT and may contribute to renal dysfunction.
机译：目的：原发性恶性高血压（MHT）可能由于肾小球超滤或纤维蛋白样坏死（FN）引起局灶性节段性肾小球硬化（FSG），并可能导致肾功能障碍。为了确定原发性MHT中FSG的发生和分布频率，我们研究了38例非洲黑人-30死后尸检和8例穿刺活检标本的肾脏活检标本。受试者：男性31位，女性7位，平均年龄46（+/- 7）岁。结果：平均血压（BP）为206 +/- 15/137 +/- 9 mmHg，中位24小时蛋白尿（四分位（IQ）范围）为5.1 g（3.3-6.5 g），中位血清白蛋白3.4 g（ 3.2-3.8 g）和血清肌酐中位数540摩尔/升（425-752摩尔/升）。在所有切片中均存在粘液样内膜增生，但在29个中可见FN（76％）。所有部分均存在肾小球硬化，并且轴向分布在7个（18％），分段分布在22个（58％）和全球分布在9个（24％）。 24小时蛋白尿中位数分别为2.8 g（0.8-3.5 g IQ范围），5.6 g（1.7-8.1 g）和3.4 g（2.6-4.0 g），相应的血清肌酐值为770μmol/ l（106- 1274摩尔/升IQ范围），522摩尔/升（248-991摩尔/升）和1230摩尔/升（920-1558摩尔/升）。结论：肾小球硬化的分布似乎与蛋白尿或血清肌酐无关，尽管节段性分布的肾小球硬化病例似乎具有最高的蛋白尿，而总体肾小球硬化患者似乎具有最高的血清肌酐水平。因此，FSG主要发生在原发性MHT中，并可能导致肾功能不全。

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