# 梗死（Infarct）

- 器官 / 系统：肾脏 / 泌尿系统（kidney / urinary-system）
- NTP 数据编号：ntp-0156
- 规范 URL：https://www.labsmart.cn/ntp/kidney-infarct.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#kidney-infarct
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/urinary-system/kidney/Infarct
- 授权：美国联邦政府作品，公有领域；引用请标注 NTP Nonneoplastic Lesion Atlas
- 适用说明：仅供科研使用，不用于临床诊断

## 一句话结论
肾梗死通常表现为边界清晰、楔形或三角形的凝固性坏死区，从被膜表面延伸至髓质。这种特征性形状源于肾脏独特的血液供应。

## 病变描述（中文）
肾梗死通常表现为边界清晰、楔形或三角形的凝固性坏死区，从被膜表面延伸至髓质。这种特征性形状源于肾脏独特的血液供应。梗死可由多种损害血液供应的原因自发产生，例如肿瘤性浸润或肾毒性物质。急性梗死具有中心坏死区，周围炎症轻微（Figure 1）。随着病变进展，坏死区附近出现明显的中性粒细胞至单核细胞浸润（Figure 2）。慢性梗死的特征是肾实质间质纤维化和被膜表面凹陷（Figure 3）。然而，将所有皮质凹陷和纤维化区域都归因于梗死可能并不恰当，因为其中一些可能代表正在消退的既往间质炎症区域。

## 诊断与分级建议（NTP 共识，中文）
梗死应诊断为梗死，而不是诊断其各个组成部分（例如，坏死、炎症、纤维化）。应根据肾脏受累范围进行分级。在病理学描述中，梗死应标明为急性或慢性，如有可能，应确定梗死的原因。相关链接：肾脏 - 纤维化 肾脏 - 炎症

## 英文原文 · Comment
Renal infarcts usually appear as well-demarcated, wedge-shaped or triangular areas of coagulative necrosis that extend from the capsular surface into the medulla. The characteristic shape results from the kidney’s unique vascular supply. Infarcts can arise spontaneously from a number of causes that compromise the vascular supply, such as neoplastic infiltrates or nephrotoxicants. Acute infarcts have a central area of necrosis with little peripheral inflammation ( Figure 1 ). As the lesion progresses, neutrophilic to mononuclear infiltrates become evident near the area of necrosis ( Figure 2 ). Chronic infarcts are characterized by renal parenchymal interstitial fibrosis and capsule surface depression ( Figure 3 ). However, ascribing an infarct to all areas with cortical depression and fibrosis may not be warranted since some might represent areas of previous interstitial inflammation that are resolving.

## 英文原文 · Recommendation
Infarcts should be diagnosed as infarcts rather than diagnosing the individual components (e.g., necrosis, inflammation, fibrosis). They should be graded according to the extent of renal involvement. In the pathology narrative, infarcts should be designated as either acute or chronic, and if possible, the cause of the infarct should be identified. Related Links: Kidney - Fibrosis Kidney - Inflammation

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_1076.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_1082.jpg

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