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目的:研究高原红细胞增多症与肾损害关系。方法:对明确诊断高原红细胞增多症合并蛋白尿患者行肾素血管紧张素Ⅰ(A1,卧位)、肾素血管紧张素Ⅱ(A2,卧位)、血浆肾素活性(PRA,卧位)及醛固酮(ALD)水平的观察并结合肾活检病理诊断进行分析研究。结果:高原红细胞增多症合并蛋白尿组与原发性慢性肾炎组、体检健康人群组比较时,其A1、A2、PRA及ALD水平均高于原发性慢性肾炎组、体检健康人群组,尤以血浆肾素活性水平升高为主。肾活检病理诊断(南京军区福州总医院肾脏病理诊断:高原红细胞增多症肾损害):(1)系膜轻-中度增生,毛细血管内红细胞淤积或瘀血,局灶节段硬化,局灶球形肾小球硬化;(2)轻度肾小管萎缩及间质纤维化;(3)动脉硬化(1~2)分。结论:高原红细胞增多症时可引起肾脏组织病变及出现临床症状,即高原红细胞增多症肾损害。
Objective: To study the relationship between high altitude polycythemia and renal damage. Methods: The patients with high altitude polycythemia complicated with albuminuria underwent renin - angiotensin Ⅰ (A1, supine position), renin - angiotensin Ⅱ (supine position), plasma renin activity (PRA, supine position) And aldosterone (ALD) levels and renal biopsy combined with pathological diagnosis analysis. Results: The levels of A1, A2, PRA and ALD in patients with high altitude polycythemia complicated with proteinuria and primary chronic nephritis were significantly higher than those in healthy people , Especially in plasma renin activity increased. Pathological diagnosis of kidney biopsy (Nanjing Military Region, Fuzhou General Hospital renal pathological diagnosis: high altitude polycythemia renal damage): (1) mesangial light - moderate hyperplasia, intrahepatic capillary red blood cell deposition or blood stasis, focal segmental sclerosis, focal Spherical glomerulosclerosis; (2) mild tubular atrophy and interstitial fibrosis; (3) atherosclerosis (1 to 2) points. CONCLUSIONS: High altitude polycythemia can cause renal tissue lesions and clinical symptoms, ie, high altitude polycythemia and renal damage.