【摘要】 <正> 系统性红斑性狼疮(简称SLE)是一种自身免疫性疾病,多器官受到损害,临床症状和病理改变比较复杂。国内较大宗的尸解材料研究尚未见有报道。我教研室从1947年5月13日到1982年2月24日在8496例尸解中确诊为本病的有23例。全部病例均作系统尸解,组织用福尔马林液固定,石腊包埋制片,HE染色,部分切片曾作PAS和纤维素染色。我们复习尸解记录和玻片,归纳描述各器官的病理改变,以期反映我国自己的材料的特点,从而提高对本病的认识,特别对狼疮性肾炎的病理组织学分型及其临床预后的关系作一探讨。更多还原

【Abstract】 Twenty-three cases of systemic lupus erythematosus ( SLE)confirmed clinico-pathologically among 8496 autopsies done from 13 May 1947 to 24 February 1982 in the Department of Pathoanatomy of Zhongshan Medical College were reviewed. The pathological findings of SLE, which were not comprehensively reported in Chinese medical literature , were systematically described in detail in this paper. The authors found that the bilateral kidneys of 15 cases showed the microscopic changes of membranous nephritis and those of 8 cases represented a mixed features of both membranous and proliferative nephritis. None of simple prolifera-tive nephritis which was frequently seen in biopsies taken with a needle was encountered in this series of autopsy material. There is no remarkable relation of the prognosis between the patients with two types of SLE-nephritis. The result of correlating the patients’ renal function with the severity of glomerular lesions illustrated that there was a correspondence between them.It is noteworthy that besides focal interstitial myocarditis( 13 cases), verrucous endocarditis ( 4 cases ),interstitial edema ( 4 cases ) or / and haematoxylin corpusales ( 3 cases) which had been generally recognized as maybe lesions of myocardium in SLE,there were 11 cases having conspicuous myocardial degenerative changes including hydropic degeneration ( 7 cases ) and focal necrosis (4 cases ) . Those changes were also described in other reports but they were not so marked as to be seen in our cases.The secondary infection of lungs was found in 21 out of total 23 cases. This finding differed greatly from that reported in the old scientific papers in which interstitial pneumonitis or intertitial fibrosis of lungs occured predominantly. It might be resulted from wide usage of immuno-inhibitor or corticoid as an effective drug ior treatment.A considerable degree of fatty degeneration of liver cells , either diffusely or focally distributed, occured most frequently (20 cases). Besides, interstitial hepatitis (3 cases),fibrinoid degeneration ( 1 case ) or hematoxylinphilic nercosis ( 1 case) of portal fibrous tissue and focal necrosis of liver parenchyma were also found. The clinico-pathological correlation also showed that the severity of hepatic damage was somewhat correspondent to the deficiency of liver function too.Lastly, the authors agreed that the hematoxylin corpusales which probably contains depolymerized DNA had specific significance in diagnosing SLE, and the apperarance of verrucous endocarditis , especially involving the ventricular endocardium was also helpful for confirmation of this desease.更多还原