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目的探讨微小病变样原发淀粉样变肾病的临床病理特点及电镜检查在老年肾病中的诊断价值。方法 1例报道结合文献复习。结果早期轻微病变样淀粉样变肾病可以没有明显的临床特征,光镜下可以表现为微小病变样,确诊必须依赖电镜诊断。结论对中老年肾病综合征患者治疗前一定要做病理诊断,即使光镜检查为微小病变,也应做电镜检查是否存在淀粉样变。电镜检查对早期淀粉样变肾病而言可能是惟一可靠的诊断手段。
Objective To investigate the clinicopathological features of primary amyloid nephropathy with minimal disease and the diagnostic value of electron microscopy in senile nephropathy. Method 1 case report combined with literature review. Results Early mild lesions like amyloidosis can have no obvious clinical features, microscopic lesions can be showed as micro-lesions, the diagnosis must rely on the diagnosis of electron microscopy. Conclusion The diagnosis of nephrotic syndrome in middle-aged and elderly patients must be done before the pathological diagnosis, even if microscopic examination for microscopic lesions, should also be electron microscopy for the existence of amyloidosis. Electron microscopy may be the only reliable diagnostic tool for early amyloidosis.