先天性肾积水输尿管狭窄段的病理及超微结构

Pathology and Ultrastructure of Narrowed Segment of Ureter in Children with Congenital Hydronephrosis

本文对28例30只小儿肾盂输尿管狭窄段进行了光学显微镜及电子显微镜检查.提示狭窄段的主要变化是平滑肌肥厚和纤维组织增生,并见肌纤维排列和走行紊乱现象.在透视电镜下平滑肌细胞显示形态、大小、排列和密度有明显改变,肌细胞内可见线粒体,高尔基氏器、粗面内质网等,但缺少基底膜、肌丝及致密体,提示为合成型的平滑肌细胞.本文对先天性肾积水的病因、发病机制以及临床有关的几个问题加以讨论.

30 sections of narrowed segment of ureter in 28 cases with congenital hydronephrosis were observed by light microscopy and electron microscopy. The results suggested that the main changes of the narrowed segment of ureter were hypertrophy of the tunica muscuJaris of the ureter and hyperplasia of the connective tissue, in addition, the muscle fibers showed an abnormal arrangement and mal-orientation. Under transmission electron microscopy the smooth-muscle cells were different from normal in morphology, size, arrangement and density. In cytoplasm of the smooth-muscle cells mito- chondria.Golgi's apparat in us and rough endoplas-mic reticulum were found, but not a basement membrane,not myofilaments or dense bodies suggesting a synthetic form of smooth muscle cell. The etiology and pathogenesis of the congenital hydronephrosis and some related clinical problems of the disease were discussed.