IgA肾病肾组织内胶原蛋白Ⅳ的分布及意义

DISTRIBUTION OF COLLAGEN Ⅳ IN KIDNEY OF IGA NEPHROPATHY AND ITS CORRELATION WITH RENAL PATHOLOGY

研究了107例IgA肾病患者肾组织中胶原蛋白Ⅳ(CⅣ)的分布及其与纤维连接蛋白(Fn)分布及肾脏病理的关系。CⅣ的分布与系膜增生相一致。在新月体、节段性及早、中期球性肾小球硬化区,CⅣ与Fn均增多,肾小管壁及间质CⅣ亦增多。CⅣ在肾小管上异常增多的程度与肾组织病理改变、肾小管萎缩、间质纤维化及炎细胞浸润呈正相关。本结果表明,新月体及肾小球硬化的发生与CⅣ及Fn在小球内过度聚积有关,肾间质炎性反应可能刺激肾小管上皮细胞大量合成CⅣ并在局部聚集,进而导致肾小管萎缩和纤维化。

The distribution of collagen Ⅳ (CⅣ) and its correlation with renal histological lesions were investigated in 107 cases with IgA nephropathy. Strong positive staining of CⅣ and Fn was found in glumerruli with crescents, segmental and global sclerosis, as well as in the tubular basement membrane and interstitium. The extent of CⅣ deposit was correlated well with tubular atrophy, interstitium fibrosis, infiltration of cells and renal pathologic changes. The results show that the increment of CⅣ and Fn in glomeruli is associated with the development of crescents, glomerular sclerosis. The inflammation of interstitium may stimulate renal tubular cells to produce extravagent amounts of CⅣ, which might further result in tubular atrophy and fibrosis.