关键词: 系膜溶解,抗血管内皮生长因子药物相关肾损害,POEMS综合症,造血干细胞移植相关肾损害

Abstract: Ｏｂｊｅｃｔｉｖｅ：To clarify the disease spectrum of mesangiolyisis and compare the clinicopathological features and prognosis of glomerular diseases manifested by mesangiolyisis.
Ｍｅｔｈｏｄｏｌｏｇｙ：Patients with native biopsyproven mesangiolyisis from Jan. 2005 to Dec. 2020 excluding diabetic nephropathy or lupus nephritis in the National Clinical Research Center of Kidney Disease. were analyzed retrospectively, and their clinicopathological data and followup information were evaluated.
Ｒｅｓｕｌｔｓ：Mesangiolysis was observed in 385 (076％) cases from 50488 native renal specimen. Focal and diffuse mesangiolysis were accounted for 8727％ and 1273％ respectively. Mesangiolysis displayed as acute phase (883％), chronic phase (4727％), and acutechronic phase (4390％). The occurence of mesangiolyisis in primary and secondary glomerular disease was 059％ and 185％, respectively. Secondary glomerular diseases included POEMS syndrome (POEMS, 100％), antivascular endothelial growth factor drugrelated renal damage (aVEGF, 875％) and hematopoietic stem cell transplantation related renal damage (HSCT, 8095％). Compare the clinicopathological and prognostic differences between the aVEGF, POEMS and HSCT groups. Patients in aVEGF group presented a higher level of protein urine (214 g／24 h) than the other two groups (091 g／24 h, 082 g／24 h). The occurence of glomerular capillary ballooning and exudative material (857％) was higher in aVEGF group. Mesangiolyisis was diffusely and evenly distributed in the glomeruli in POEMS group. Dilatation of capillary loops could be often observed in the HSCT group, and the mean average width of subendothelial space was also wider than the other two groups. Patients in the three groups had an overall good survival of kidney.
Ｃｏｎｃｌｕｓｉｏｎ：Mesangiolyisis was observed in a wide range of glomerular diseases, but appears to be a rather infrequent occurrence. Diseases presenting as diffuse mesangiolysis are distinctive in pathological morphology and clinical manifestations, and the role of mesangiolysis in the process of such diseases as to pathophysiological significance and its impact on prognosis remains to be explored in depth.

Key words: mesangiolyisis, anti-vascular endothelial growth factor drug-related renal damage, POEMS syndrome, hematopoietic stem cell transplantation-related renal damage