轻度系膜增生性肾小球肾炎患者肾小管间质损伤的病理分析

The pathological analysis of tubulointerstitial damage in mild mesangial proliferative glomerulonephris patients

目的分析轻度系膜增生性肾小球肾炎(mild mesangial proliferative glomerulonephris,mild-MsPGN)患者肾组织的病理组织学变化,评价肾小管间质损伤程度。方法临床诊断原发性肾病综合征患者,肾穿刺活检确诊为mild-MsPGN者,收集患者临床资料,肾穿刺活检,过碘雪夫酸染色,图像分析系统下观察、分析肾组织病理变化,进行肾小管间质损害评分,并分析该评分与血钙变化的关系。结果临床诊断原发性肾病综合征30例患者,血清肌酐为124.69±64.39 mol/L,尿素氮增高,血钙水平低于正常参考值;过碘雪夫酸染色显示肾小球轻度系膜增生,并有不同程度的肾小管间质损害,其评分值为1.61±1.31。血钙水平与肾小管间质损害评分之间无明显相关性。结论 mild-MsPGN患者肾组织除了存在轻度系膜增生外,还存在不同程度的肾小管间质损害。

Objective To analyze histopathological of nephridial tissue and estimate the degree of tubulointerstitial damage（TID）.Methods Primary nephrotic syndrome patients who were final diagnosed mild mesangial proliferative glomerulonephris（mild-MsPGN） by renal needle biopsy.Clinical data were collected.Renal tissue was stained by periodic acid-schiff after renal needle biopsy.Pathological change was observed under microscope.TID estimation were carried out semiquantitative score.The relationship between the semiquantitative score and the change in blood calcium was analyzed.Results Tthinty the level of primary nephrotic syndrome patients were diagnosed according to 24 hours urine protein quantitation and plasma albumin.The serum creatinine was 124.69±4.39μmol/L.The blood urea nitrogen also was higher,but blood calcium was lower than normal reference value.Mild mesangial proliferation was observed in glomerulus of kidney by periodic acid-schiff staining.There are different degree TID.The value of TID estimation was 1.61±1.31.There were not correlation between TID and the level of blood calcium.Conclusions There are not only mild mesangial proliferation,but also different degree of TID in renal tissue of mild-MsPGN patients.