流行性出血热多尿期肾小球毛细血管壁通透性的研究

PERMSELECTIVITY OF GLOMERULAR CAPILLARY WALL IN POLYURIC PHASE OF EPIDEMIC HEMORRHAGIC FEVER

本文对8例流行性出血热(EHF)及对照组测定了中性右旋醣酐-40(d)和内源性血浆β2微球蛋白(β2m),白蛋白(alb)和IgG的清除分数(θ).结果发现,在EHF多尿初期(Gla),其分子大于44 A的θd和θIgG均呈显著增高,而小分子的θd又低于正常,提示肾小球滤过膜'大孔'数的增多和负电荷的丢失.在多尿后期,大分子θd和θIgG已呈明显下降,提示滤过膜通透性已得到一定修复.

Fractional clearance of uncharged dextran 40(θd)and anionic proteins(θp),B2M,albumin and IgG were studied in 8 cases with epidemic hemorrhagic fever(EHF),the early stage of polyuric phase as Gla and late stage as Glb.The membranous nephropathy(G2) and normal individuals(G3)served as control.The results showed that the θd of larger molecule(≥44A)and θIgG in Gla were significantly higher,but the molecular size between 24～32 A were significantly lower than in G3.In Glb,the larger molecular θd and θIgG had significantly lowered.The results comfirmed that in early stage of polyurie phase of EHF,proteinuria was due to an increase of'large pore'number and a reduction of intrinsic negative charge in glomerular filter and that in polyuric phase,the function of glomerular capillary wall recovered earlier and more complete than that of the tubules.