IgA肾病肾小球毛细血管内血浆蛋白淤积与微血栓及IgA沉积的关系

目的　观察IgA肾病 (IgAN)肾小球毛细血管内血浆蛋白平均吸光度 (MAPG)变化与微血栓形成及IgA沉积之间的关系。方法　用图像分析仪定量测定 5 5例IgAN肾穿标本MAPG和IgA沉积物 ,伪彩色分割显示其血浆区吸光度值的变化层次 ;比较高MAPG组与低MAPG组之间微血栓形成率、IgA沉积量的差异。结果　高MAPG组IgAN的微血栓形成率和IgA沉积量显著高于低MAPG组 ;伪彩色显示高MAPG组的肾小球毛细血管内血浆蛋白聚焦 ,微血栓周围血浆蛋白浓度明显较高。结论　IgAN肾微循环内血浆蛋白浓度升高会促进IgA免疫复合物沉积和微血栓形成。

The relationship between plasma protein stasis in glomerular capillary and microthrombus and IgA deposit in IgA nephropathy

Objective To observe the relationship between the change of mean light absorbency of plasma protein (MAPG) in glomerular capillary and the formation of microthrombus and IgA deposit in IgA nephropathy (IgAN). Methods An image analysis system was used in a quantitative determination of MAPG and IgA deposit of renopuncture samples in 55 patients with IgAN. The change gradation of light absorbent values in plasma area was measured with pseudo-color separation method. A comparison was made for the differences of microthrombus formation rate and IgA deposit volume between the high and low MAPG groups. Results Microthrombus formation rate and deposit volume of IgA in high MAPG group were singnificantly higher than those in low MAPG group. Pseudo-color examination showed plasma protein aggregation remarkable in glomerular capillary in high MAPG group and obvious rise of plasma protein concentration around the microthrombus. Conclusion The rise of concentration of plasma protein in renal microcirculation inIgAN will accelerate the sedimentation of IgA immune compounds and the formation of microthrombus.