肾小球薄基底膜病的超微病理诊断

Ultrastructural pathologicl diagnosis of thin glomerular basement membrane disease

对 110 0例肾活检中 5 2例 (4 7% )肾小球薄基底膜病 (TBMD)进行回顾性总结。 5 2例TBMD中 ,4 6例为儿童(88 5 % ) ,6例为成人 (11 5 % )。TBMD电镜下以基底膜弥漫变薄为特征。成人和儿童正常GBM厚度不同 ,因此诊断TBMD标准亦不相同。对于TBMD的诊断必须密切结合临床和病理检查 ,应符合以下几点 :1、临床表现为单纯复发性血尿 ,2、光镜和免疫荧光正常 ,3、电镜下无电子致密物沉积 ,仅表现基底膜弥漫变薄 :成人GBM厚度 <2 5 0nm ,6～ 10岁儿童GBM厚度 <2 0 0nm ,5岁以内GBM厚度 <15 0nm。

cases in 1100 cases of thin glomerular basenment membrane disease (TBMD) were studied. 46 cases were children (86.5%), 6 cases were adult (11.5%).The ultrastructural characteristic of TBMD was diffuse attenuation of the glomerular basenment membrane (GBM).The diagnostic standard was varied in adult and children. The thicknees of GBM was<250nm in the adult,<200nm in children aged 6～10 and <150nm in younger than 5.The diagnosis and classification of TBMD were disscused.