梗阻性尿路病继发肾发育不良时的肾小球大小：对胎羊模型的进一步探索

Glomerular size in renal dysplasia secondary to obstructive uropathy: a further exploration of the fetal lamb model.

作者信息

Kitagawa H, Pringle K C, Zuccollo J, Koike J, Nakada K, Ikoma M, Seki Y

机构信息

Division of Pediatric Surgery aSt Marianna University School of Medicine, Kawasaki, Japan.

出版信息

J Pediatr Surg. 2000 Nov;35(11):1651-5. doi: 10.1053/jpsu.2000.18344.

DOI:10.1053/jpsu.2000.18344

PMID:11083445

Abstract

BACKGROUND/PURPOSE: Creating an obstructive uropathy early in glomerulogenesis would produce multicystic dysplastic kidneys (MCDK). Measuring the mean planar area of the glomeruli (GMPA) may clarify the pathogenesis of MCDK.

METHODS

Fetal lambs at 60 days' gestation had their left ureter ligated and were delivered by cesarian section at 145 days' gestation. Kidney weight and length were recorded. GMPA in 3 zones (outer, middle, inner) of the sectioned kidney was measured using a computerized planimeter. The obstructed kidneys were compared with contralateral unobstructed kidneys. The unpaired Student's t test was used to determine significance.

RESULTS

One ewe miscarried. Four of 5 (80%) 60-day lambs survived. All had dysplastic kidneys. Mean kidney weights were 4.3 +/- 0.84 g in MCDK and 16.8 +/- 3.6 g in controls (P< .05). The GMPA of the outer, middle, and inner zones of the MCDK were 2.7 x 10(-3) mm2, 3.2 x 10(-3) mm2, and 4.0 x 10(-3) mm2, respectively. Controls were 2.8 x 10(-3) mm2, 4.4 x 10(-3) mm2, and 6.0 x 10(-3) mm2. The glomeruli of 60-day fetal kidneys were 3.0 x 10(-3) mm2, 6.1 x 10(-3) mm2, and 11.0 x 10(-3) mm2. MCDK had smaller glomeruli in the inner and middle zones than controls.

CONCLUSION

Fetal glomeruli appear to grow from the inner zone of the kidney. Early urinary tract obstruction stops this growth.

摘要

背景/目的：在肾小球发生早期造成梗阻性尿路病会导致多囊性发育不良肾（MCDK）。测量肾小球的平均平面面积（GMPA）可能会阐明MCDK的发病机制。

方法

妊娠60天的胎羊左侧输尿管被结扎，并于妊娠145天时通过剖宫产娩出。记录肾脏重量和长度。使用计算机化面积测量仪测量切开肾脏的3个区域（外层、中层、内层）的GMPA。将梗阻侧肾脏与对侧未梗阻肾脏进行比较。采用非配对学生t检验确定差异的显著性。

结果

1只母羊流产。5只60天龄的羔羊中有4只（80%）存活。所有存活羔羊均患有发育不良肾。MCDK的平均肾脏重量为4.3±0.84g，对照组为16.8±3.6g（P<0.05）。MCDK外层、中层和内层区域的GMPA分别为2.7×10⁻³mm²、3.2×10⁻³mm²和4.0×10⁻³mm²。对照组分别为2.8×10⁻³mm²、4.4×10⁻³mm²和6.0×10⁻³mm²。60天龄胎儿肾脏的肾小球面积分别为3.0×10⁻³mm²、6.1×10⁻³mm²和11.0×10⁻³mm²。MCDK中层和内层区域的肾小球比对照组小。