摘要
本研究着重观察了２６例非胰岛素依赖性糖尿病（ＮＩＤＤＭ）肾病患者肾小管间质病变的特点，包括肾小管功能的改变、肾组织学检查及部分患者的尿ＥＧＦ，对小管间质损伤在糖尿病肾病（ＤＮ）发生发展中的作用作了初探。结果发现：①ＮＩＤＤＭ肾病小管间质功能受损具有无明显节段性分布的特点，既有近端小管细胞损伤，也有远端小管的损伤；在形态学上表现为肾小管萎缩、基膜增厚、间质扩张、弥漫炎细胞浸润及不同程度的纤维化。②在肾小球滤过功能明显受损之前，小管间质病变即已出现，并随着肾功能的恶化而逐步加重，提示小管间质损害在ＤＮ的发生发展中起着与肾小球病变同样重要的作用。③肾功能未明显受损、小管间质病变程度较轻的ＤＮ患者，尿ＥＧＦ明显增高。随着肾功能的明显恶化，小管间质萎缩纤维化的加重，尿ＥＧＦ排泄量也逐渐降低，表明ＥＧＦ很可能参与了ＤＮ小管间质病变，在其损伤的早期阶段起了一定作用。
The changes of
tubular-interstitiumincluding tubular function, histolosy and urineEGF were assessed in 26
cases with noninsulin-dependent diabetic nephropathy (NIDDM)and itsrole in the initiation and
progression of diabeticnephropathy (DN) was discussed. The resultsshowed:①The losses of
tubular function werenot segmently distributed, covering bothproximal and distal tubules. The
histolosic studydemonstrated the presence of tubular atrophy,thickening of rubular basement
membane,interstitial expansion, as well as infiltratinginflamatory cells and various degree of
fibrosisin the interstitium.②The alterations of tubularinterotitium appeared before the obvious
declineof GFR and asgravated with the deterioration ofthe renal function. This susgeeted that
rubular-interstitium damage was also important in theprocess of DN. ③The DN patients with
unsevererenal disfunction and slight tubular interstitiumlesions had higher levels of urine EGF.
Theamount of urine EGF decreaed with thedeterioration of renal function and aggravationof
interstitial fibrosclerosis. EGF may beinvolved in the changes of tubular interstitium.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1994年第4期272-275,共4页
Chinese Journal of Nephrology,Dialysis & Transplantation
