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放射性肾病是指肾经电离辐射后肾实质和血管受损。临床表现为蛋白尿、血尿、氮质血症、贫血和高血压等。病理上主现表现为肾小球毛细血管襻增厚、系膜细胞溶解、上皮细胞肿胀、基膜双轨形成、肾小管上皮细胞萎缩、肾间质纤维化等。放射性肾病确切的发病机制仍不清楚,目前认为,主要与肾固有细胞损伤、尤其是血管内皮细胞损伤、肾素-血管紧张素系统(RAS)在某种程度上激活、氧化应激反应增加等因素有关。有研究认为,血管紧张素转换酶抑制剂(ACEI)和血管紧张素Ⅱ受体拮抗剂(ARB)是治疗放射性肾病的有效药物。作者就上述问题作一综述。
Radioactive nephropathy refers to renal impaired renal parenchyma and blood vessels after ionizing radiation. Clinical manifestations of proteinuria, hematuria, azotemia, anemia and hypertension. The main pathological manifestations of glomerular capillary loop thickening, mesangial cell lysis, epithelial cell swelling, double-basement membrane formation, renal tubular epithelial atrophy, interstitial fibrosis and so on. The exact pathogenesis of radiation nephropathy remains unclear, and is currently believed to be primarily associated with renal intrinsic cell injury, particularly vascular endothelial cell injury, activation of the renin-angiotensin system (RAS) to some extent, and increased oxidative stress response Factors related. Some studies suggest that angiotensin converting enzyme inhibitor (ACEI) and angiotensin Ⅱ receptor antagonist (ARB) is an effective drug for the treatment of radiation nephropathy. The author reviews the above questions.