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目的总结１７例成人肾小球轻微病变伴发急性肾功能衰竭，以进一步了解该类患者急性肾衰发生的成因、机制、特征及预后。方法肾穿刺活检，组织行光镜、电镜及免疫荧光学检查。结果本组男女之比４７∶１；年龄３０～４０岁。临床上以肾病综合征为主要表现。病理学上肾小球的主要表现为肾小球轻微病变；肾小管间质的病变主要以肾小管细胞变性、扁平化、微绒毛脱落、单个小管细胞脱落、坏死及间质水肿纤维化等亚致死性损伤为特征。本组患者从发现肾病到肾衰发生的平均时间为（４０±１７）天。患者经早期激素治疗及适当的支持疗法后预后良好，从肾衰发生到临床恢复的平均病程为（６４±２１）天。结论成人肾小球轻微病变伴发急性肾衰可能为肾小管间质的亚致死性损伤所致；这类病变因其病理学改变不甚典型而易被忽视；该类患者早期使用激素可能对肾功能改善及病变恢复有一定的帮助。
Objective To summarize 17 cases of mild glomerular lesions in patients with acute renal failure, to further understand the causes of acute renal failure in these patients, mechanism, characteristics and prognosis. Methods Kidney biopsy, histological examination with light microscopy, electron microscopy and immunofluorescence. Results The ratio of men to women in this group 4 7:1; age 30 to 40 years. Nephrotic syndrome clinically as the main performance. Pathological glomerular main manifestations of minor glomerular lesions; tubulointerstitial lesions mainly in renal cell degeneration, flattening, microvilli shedding, a single tubular cells shedding, necrosis and interstitial edema, fibrosis and other sub- Fatal injuries are characterized. The average time from finding kidney disease to developing renal failure was (40 ± 17) days. Patients with early hormone therapy and appropriate supportive therapy after a good prognosis, from the occurrence of renal failure to clinical recovery of the average duration of (64 ± 21) days. Conclusions The mild glomerular lesions in adults with acute renal failure may be caused by sublethal damage of tubulointerstitium. Such pathological changes are often overlooked because of their pathological changes. The early use of hormones in these patients may be Improvement of renal function and pathological recovery have some help.