糖尿病肾病患者线粒体结构变化对肾小管病理损伤的影响分析

Effect of mitochondrial structural changes on pathological injury of renal tubules in patients with diabetic nephropathy

目的观察糖尿病肾病(DN)患者的肾小管病理损伤程度和肾小管细胞线粒体的超微结构异常变化,分析线粒体结构改变对肾小管损伤的致病作用。方法从病理标本库筛选20例DN患者的肾活检组织,并将20例微小病变患者作为对照组。常规组化病理检查进行肾脏损伤等级评分,透射电镜观察比较肾小管细胞线粒体的超微结构变化,并对线粒体变化和肾小管损伤进行相关性分析。结果和对照组比较,DN组的肾小球和肾小管均出现特征性病理损伤,且肾小管细胞的线粒体出现片段化断裂、体积减小和线粒体嵴溶解的异常超微结构改变。含异常结构线粒体的肾小管细胞数量和肾小管病理损伤存在正相关。结论线粒体结构异常变化是引起DN患者肾小管损伤的一个重要致病因素,靶向线粒体的药物将为有效治疗该疾病提供新的思路。

Objective To observe the extent of renal tubular injury and the abnormal ultra-structural changes in tubular mitochondria among patients with diabetic nephropathy（DN）, and to analyze the pathological effect of mitochondrial structural changes on renal tubular injury. Methods The renal biopsy of 20 patients with DN and 20 patients with minimal change disease as control group were selected from the pathological specimen database. The degree of renal injury was assessed by histo-pathological examinations, and the ultra-structural changes of mitochondria in renal tubular cells were observed by transmission electron microscopy, which help to analyze the correlation between mitochondrial changes and renal tubular injury. Results Compared with the control group, the glomeruli and renal tubules in the DN group exhibited characteristic pathological lesions. Notably, the mitochondria of tubular cells exhibited fragmentation,volume reduction, and abnormal ultra-structural changes of mitochondrial lysis. There was a positive correlation between the number of renal tubular cells with abnormal structural mitochondria and pathological lesions of renal tubules.Conclusion Abnormal structural change of mitochondria is an important pathogenic factor that induces renal tubular injury in DN patients. Drugs targeting mitochondria will provide a new insight into the effective treatment of the disease.