胶原Ⅲ肾病

胶原Ⅲ肾病（collagentype Ⅲ glomerulonephroPathy）,又名胶原纤维性肾小球病（collagenofibrotic glomerulopathy）,是近年来认识到的一种罕见的特殊的肾小球疾病。主要表现为肾小球内出现大量异常Ⅲ型胶原沉积,它由超微结构发现胶原纤维,经免疫荧光染色判定为Ⅲ型胶原而命名。1979年Arakawa等首先报告2例患者,其肾小球内存在胶原纤维,而无指甲-髌骨综合征的临床表现,当时并未证实肾小球内胶原纤维的类型,直至1990年Ikeda等采用免疫组化的方法首先证实了肾小球内沉积的胶原为Ⅲ型胶原。1991年Arakawa等和Imbasciati等将该病命名为胶原Ⅲ肾病,目前沿用的胶原Ⅲ肾小球病（collagen type Ⅲ glomerulopathy）由1991年Imbasciati等命名。     

羊踯躅根对慢性肾小球肾炎大鼠核因子κB表达的影响

细胞因子诱导肾小球系膜细胞增殖和细胞外基质的过度产生在肾损害过程中发挥了重要的作用.核转录因子κB（NF-κB）是一种重要的转录调节因子,在体机炎症反应和免疫调节中扮演了重要的角色.     

Variation of serum monocyte chemoattractant protein-1 in patients with diabetes and metabolic syndrome

This study investigated the variation of serum monocyte chemoattractant protein-1(MCP-1) in patients with both diabetes mellitus(DM) and metabolic syndrome(MS).Based on the International Diabetes Federation(IDF) diagnostic criteria,93 patients enrolled in this study were divided into four groups:normal control(NC),simple DM,simple MS,and DM plus MS(DM-MS) groups.The main measures included height,weight,waist circumference(WC),hip circumference,blood pressure,fasting blood glucose,insulin resistance index(HOMA-IR),serum triglyceride(TG),HDL-ch,LDL-ch,and MCP-1.The results showed that the serum levels of MCP-1 in the DM-MS group were significantly increased as compared with those in the DM and MS groups(P<0.05),and the increase in the MCP-1 level in the DM group was much higher than in the MS group(P<0.05).The DM-MS group had the highest HOMA-IR levels,followed by MS,DM and NC groups(P<0.05).Correlation tests showed that the association of MCP-1 with age,HDL-ch,or LDL-ch was insignificant,whereas that of MCP-1 with body mass index(BMI),waist hip rate(WHR),WC,systolic blood pressure(SBP),diastolic blood pressure(DBP),TG,and HOMA-IR was significantly positive.It was concluded that circulating MCP-1 was substantially increased in patients with both DM and MS as compared with that in the patients with DM or MS alone,and the central obese state may contribute to a more vicious proinflammatory condition and insulin resistance in patients with diabetes.     

真性红细胞增多症相关性肾损害临床病理分析

目的了解真性红细胞增多症相关性肾损害临床和肾脏病理特点。方法回顾性分析2例真性红细胞增多症相关性肾损害患者的临床特征及肾脏病理表现。结果1例患者以水肿、蛋白尿、血尿为主要表现,1例患者以肾功能不全为主要表现。2例患者均有红细胞及血红蛋白明显升高,骨髓细胞学检查红系增生异常显著。2例肾脏病理改变的共同点为毛细血管袢高度扩张,充斥大量红细胞,间质血管腔内见大量红细胞堆积。2例患者经羟基脲以及抗凝、改善微循环等治疗后病情好转。结论真性红细胞增多症相关性肾损害的临床表现多种多样,可能先于血液系统典型表现,肾脏病理检查有助于诊断和鉴别,病理改变以毛细血管袢高度扩张充满红细胞为主要特点。     

脂多糖诱导下急性肾功能衰竭小鼠肾脏中TOLL样受体4的表达

目的:探讨TOLL样受体4(TLR4)在脂多糖(LPS)诱导的小鼠急性肾功能衰竭(ARF)肾脏中表达及意义。方法:建立LPS诱导的小鼠ARF模型。应用免疫组织化学SABC法、Western blot及RT-PCR法检测肾组织TLR4蛋白及mRNA的表达变化。TUNEL法检测肾脏的凋亡情况。结果:TLR4在正常组(NG)肾脏中主要分布于肾小管、管周、肾间质区,肾小球系膜区也有表达,而ARF组TLR4在上述区域的表达显著增加,以近端小管、肾间质、远端小管、肾血管等部位较明显,两组光密度值比较有明显差异(P<0.05);TLR4的表达与肾功能的改变呈正相关(r=0.91);与NG组相比,ARF组的TLR4蛋白及mRNA水平的表达显著上调,以造模24 h后最明显;TUNEL法显示凋亡小体主要出现在ARF组肾脏的近端小管及管周围,肾小球无明显变化。结论:TLR4在脂多糖诱导的小鼠ARF肾脏中有较高表达,同时在其肾近端小管及小管周围组织发现较明显的凋亡小体。二者在ARF发病中可能起重要作用。     

血清IgA-FN、Ⅳ型胶原在IgA肾病患者中的临床意义

目的　探讨IgA肾病患者血清IgA 纤维连接蛋白聚合物 (IgA FN)水平与其病理类型之间的关系及临床意义。方法　对 2 7例IgA肾病患者 ,根据肾脏组织病理学程度改变分为Ⅰ～Ⅲ级组、Ⅳ级组、Ⅴ级组。采用ELISA方法测定血清IgA FN、Ⅳ型胶原水平 ,并分析其与血肌酐、2 4小时尿蛋白定量和血压之间的关系。 结果　①血清IgA FN水平在Ⅳ级组最高 ,Ⅴ级组最低 (P <0 .0 5 ) ;②Ⅰ～Ⅲ级组、Ⅳ级组患者血清IgA FN与Ⅳ型胶原呈正相关性(r =0 .6 3,P <0 .0 5 ) ,与 2 4小时尿蛋白定量呈正相关 (r =0 .5 8,P <0 .0 5 ) ,Ⅴ级组二者无明显相关关系 ;③血清IgA FN水平与血肌酐水平和血压无相关性。 结论　IgA肾病患者血清IgA FN水平与IgA肾病病理严重程度有关 ,早期检测有助于早期诊断