先天性肾积水肾脏细胞凋亡的病理及其临床意义

Apoptosis of renal tubular cell in congenital hydronephrosis

目的 检测先天性肾积水肾脏细胞凋亡的发生 ,并探讨其临床意义。方法 应用电镜、DNA原位缺口末端标记法及DNA电泳检测 15例先天性肾积水患儿患肾细胞凋亡 ,其中轻、中、重度肾积水各 5例。结果 先天性肾积水肾脏有细胞凋亡发生 ,可见细胞核周边染色质凝集及凋亡小体。重度肾积水肾脏平均凋亡指数为 0 .0 94± 0 .0 17,中度肾积水为 0 .0 3 3± 0 .0 17,轻度肾积水为0 .0 0 2± 0 .0 0 3 ,三者相比具有显著性意义 ,并且随着肾积水程度的加重 ,凋亡细胞数增多。 1例中度肾积水和 5例重度肾积水肾组织电泳带型呈典型的“梯形结构”。

Objective To detect apoptosis in congenital hydronephrosis and discuss the clinical significance. Methods Apoptosis was detected in 15 cases with congenital hydronephrosis (mild 5,moderate 5,severe 5) by electromicroscopy,in situ DNA fragment labeling and DNA fragmentation electrophoresis.Results Apoptosis was detected in the kidneys with congenital hydronephrosis.Margination of nuclear chromatin was identified. Round apoptotic bodies were seen. The mean apoptotic index was 0.0941±0.017 in the severe hydronephrosis, 0.0325±0.0169 in the moderate and 0.0021±0.0031 in the mild.There was significant difference between severe and moderate hydronephrosis ( P = 0.0005 ).There was also significant difference between moderate and mild hydronephrosis,( P = 0.0154 ).The more severe the hydronephrosis,the more prominent the apoptosis.In addition, five kidneys with severe hydronephrosis and one kidney with moderate hydronephrosis showed typical apoptotic bands.Conclusion Apoptosis may play a role in renal damage in hydronephrosis.