肾病综合征管周毛细血管网改变的致病作用

目的研究肾小管周毛细血管网在肾病综合征中的改变,探讨间质微血管系统改变在肾病综合征患者间质纤维化过程中的可能性致病作用。方法采用免疫组化SP法,在蛋白质水平检测72例肾组织标本(肾病综合征组50例,对照组22例)肾小管上白蛋白沉积,同时观察肾小管周毛细血管组织学和形态学的改变以及分析肾组织纤维化程度。结果与对照组比较,肾小管周毛细血管分布密度,管腔开放程度与白蛋白的沉积之间有显著的负相关(r=-0.861,r=-0.865,r=-0.869,P<0.01);肾小管间质纤维化与肾小管周毛细血管分布密度,血管腔面积亦呈显著性负相关(r=-0.959,r=-0.770,r=-0.907,P<0.01)。结论在肾病综合征中,肾小管刷状缘白蛋白重吸收增加,可能是导致肾小管周微血管网密度降低,血管闭塞程度增加,促使肾间质纤维化发生、发展的关键因素之一。

Study on the Potential Role of Peritubular Capillaries Alteration in Fibrosis Progresss of Nephrotic Syndrome

Objective To investigate the potential role of peritubular capillaries in fibrosis progresss of nephrotic syndrome,we study the alteration of them in renal tissues.Methods The deposition of albumin in 72 casesthe nephrotic syndrome group(50cases and the control group 22cases)of renal tissues was detected using immunohistochemistry SP method.Detection of the morphology and histology alteration of peritubular capillaries and the degree of fibrosis in renal tissues were also performed.Results The MVD and the peritubular capillary lumen size were significantly negative correlation with the deposition of albumin(r=-0.861,r=-0.865,r=-0.869,P<0.01)and the the degree of interstitial fibrosis(r=-0.959,r=-0.770,r=-0.907,P<0.01).Conclusion These findings strongly support the idea that the reabsorption of albumin maybe one of the major factors to the disruption of PTC,vascular occlusion and interstitial scarring.