低分子右旋糖酐联用速尿对阿霉素肾病鼠足突形态的影响

The Effects of Low Molecular Dextran and Furosemide to Anionic Sites of Glomerular Basement Membrance

目的建立大鼠微小病变型肾病综合征模型,观察低分子右旋糖酐对肾病综合征水肿状态时肾小球基底膜足突形态的影响。方法采用连续式静脉输液法给药。标本用透射电镜观察,通过体视学方法比较正常组、模型组、盐水组(生理盐水+速尿)与右糖组(低分子右旋糖酐+速尿)肾小球基底膜足突形态的变化。结果正常组足突呈细长的指状突起,相邻足突之间的间隙及裂孔隔膜清楚可见;模型组足突广泛融合,足突间隙及裂孔隔膜消失;盐水组足突绝大部分处于融合状态,小部分虽未融合但仍处于明显肿胀的状态;右糖组足突肿胀明显减轻,表现为足突局段融合、局段肿胀与局段完全恢复正常混同存在的现象,多数足突间隙逐渐显现,有些甚至可清楚的看到裂孔隔膜。体视学形态计量结果表明,正常组与模型组,正常组与盐水组,右糖组与模型组,右糖组与盐水组这4对配组间体积密度、面密度及比表面均有显著差异或高度差异(P<0.05 or P<0.01);而右糖组与正常组、模型组与盐水组之间体积密度、面密度无差异(P>0.05),比表面有显著差异(P<0.05)。结论低分子右旋糖酐应用于水肿状态的肾病综合征,可以显著减轻足突肿胀并逐渐解除其融合状态。

Objetive To investigate the effect of low molecular dextran（LMD）and furosemide under edema state on anionic sites（AS）of glomerular basement membrance（GBM）by establishing the rat models of minimal change nephrotic syndrome（MCNS）.Methods Low molecular dextran（LMD）and furosemide were given by continuously intravenous drip.The speccimens were observed under transmission electron microscope.The changes of AS in normal group,model group,normal saline group（normal saline ＋ furosemide）and LMD group（LMD＋furosemide）were compared after stained with methods of polyethyleneimine（PEI）.Results The AS of normal group were equal and regularly distributed with relatively larger particles and without loss of the number.While irregularly and unevenly distributed AS with loss of particles were noticed in other groups.The degree of losss of AS in each group from severe one to light one was in the order of model group,normal saline group,LMD group.the number of AS in inner and outer tectorium of GBM in the three groups was significantly differrent（P0.01）,but without significant difference between LMD group and normal group（P0.05）.Conclusion LMD and furosemide had an effect of quickly recovering the number of AS while applying to MCNS with edema state.