摘要
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。
Radiation nephropathy refers to the damage of renal parenchyma and blood vessel caused by sufficient exposure to ionizing radiation. The clinical presentation includes proteinuria , hematuria , anemia, hypertension, and azotemia. Histological features include capillary loop thickening, mesangiolysis, formation of the double contours , subendothelial swelling, tubular atrophy, and tubulointerstitial fibrosis. Similar changes are seen in a variety of experimental animal models. The pathogenesis of radiation nephropathy remained unclear. It is reported that radiation-induced changes in kidney cell phenotype, renin angiotensin system （RAS） and oxidative stress is clearly involved. Multiple experimental studies have shown that antagonism of the RAS is beneficial, even when not initiated until weeks after irradiation. Recent findings suggest a similar benefit in clinical radiation nephropathy.
出处
《医学研究生学报》
CAS
2007年第8期873-877,共5页
Journal of Medical Postgraduates
基金
南京军区医学科学技术研究"十一五"计划面上课题资助项目(批准号:06MA113)
关键词
放射性肾病
临床病理
发病机制
Radiation nephropathy
Histological feature
Pathogenesis
