1～5岁肾小球微小病变患者肾小球基底膜厚度的初步研究

Stereologic analysis of the thickness of glomerular basement membrane in 1 to 5 years old children with minimal change disease

目的了解1～5岁肾小球微小病变(MCD)患儿肾小球基底膜(GBM)的厚度。方法选择年龄为1～5岁,无家族遗传病史或其他病史、不伴有血尿、经临床诊断为原发性肾病综合征,免疫荧光染色全部阴性或仅有少量非特异性沉积,光镜未见异常,并经透射电镜确诊为MCD的病例,在透射电镜下观察到至少2个肾小球的35个病例入选。10 000倍下,根据等距离曲线移动原则对每个样本的2个肾小球分别拍照10张,以4000 nm宽度设定测试网,从测试线与内皮细胞相交的点向GBM作垂直线与足细胞相交处的距离为GBM截面宽度,据此计算出GBM调和平均厚度。结果和结论随年龄增长GBM厚度增加,部分年龄段差别有统计学意义,尚需进一步研究。

Objective To assess the thickness of glomerular basement membrane （GBM） in minimal change＇ disease （MCD） in children from 1 to 5 years old. Methods Thirty - five samples from children with MCD between 1 and 5 years old who had at least two glomeruli under the transmission electron mi- croscopy were selected. The patients were diagnosed clinically as primary nephropathy syndrome without hematuria, familial history of hereditary disease, or other disease and were confirmed to be normal by light microscopy. Ultrathin sections were observed by electron microscopy at magnification of 10,000. Two glomeruli were observed for each sample. Ten photos were taken from each glomerular. Test grids were set by Scandium system. According to the mean wideness of cross - section of GBM, the harmonic mean of GBM for each sample was calculated, which was referred to as mean -＋ SD （ranged from minimum to maximum） nm. Results and Conclusions The results of the 35 cases show that the thickness of GBM is increasing with the increase of age. Pairwise analysis demonstrates significance except between 2 and 3/4 years. Further investigations are required.