小儿肾小球疾病尿免疫复合物检测与肾免疫病理学对比研究

INVESTIGATION ON URINARY IMMUNE COMPLEXES IN VARIOUS HISTOPATHOLOGIC FORMS OF GLOMERULAR DISEASES IN CHILDREN

本研究试图了解尿免疫复合物（ＵＩＣ）检测能否反映肾小球所发生的免疫病理改变。结果表明ＵＩＣ主要出现于肾小球病变严重的病人，如毛细血管内增生性肾炎（ＥｎＰＧＮ），膜性肾病（ＭＮ），弥漫增殖性肾炎（ＤＰＧＮ）或免疫复合物（ＩＣ）介导致病的临床类型如急性链球菌感染后肾炎（ＡＰＳＧＮ），狼疮肾炎及部分肾炎性肾病（ＮＮＳ）患儿尿液之中。ＵＩＣ阳性病人肾小球多伴有ＩｇＧ及Ｃ３沉积，分析表明ＩｇＧ类ＵＩＣ检测能提示ＩｇＧ类ＩＣ所致肾病变，长期使用激素治疗的迁延性肾病变不易检出ＵＩＣ。

rinary immune complexes(UICs)were detennined and the samples of renal biopsy were alsoinvestigated by light, immunofluorensence and electron microscopy in 41 children with glomerulardiseases. The results showed that UICs wrer found in 7/7 endothelis proliferative glomerulonephritis(-EnPGN),5/6 membranous nephritis(MN)and 1/1 diffuse proliferative glomerulone phritis(DPGN):UICs also were predominantly found in patients with immune complex mediated glomerulonephri-tis,such as acute poststrepto-coccal glomerulo nephritis (APSGN),lupus nephritis(LN)and somenaphritic nephrotic syndrom(NNS).Tbe poaitive results of UICs were closely correlated withdeposition of IgG,C3 in glomeruli.Our results indicat that UICs may be detected in children with serrious histopa thologic formsof glomerrular diseases(Enpgn,MN,DPGN),Determination of UICs may provide a noninvasivemethod for clinical assesment of patients with immunologically mediated glomeruler disorders.