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各种肾脏疾病中肾皮质和外髓质间质增宽及肾小管上皮细胞变化对肾功能的影响。

The consequences for renal function of widening of the interstitium and changes in the tubular epithelium of the renal cortex and outer medulla in various renal diseases.

作者信息

Mackensen-Haen S, Bohle A, Christensen J, Wehrmann M, Kendziorra H, Kokot F

机构信息

Institute of Pathology, University of Tübingen, Germany.

出版信息

Clin Nephrol. 1992 Feb;37(2):70-7.

PMID:1551253
Abstract

The following parameters were measured in 63 renal biopsy specimens, most of which exhibited mesangioproliferative glomerulonephritis: the relative area of the interstitium and the area of the capillaries in the cortex and outer stripe of the outer medulla, and the area of the epithelium of the proximal tubules and of the ascending limbs of Henle's loop. The percentage of hyalinized glomeruli was also determined. Investigation of correlations between these values and parameters of renal function revealed the following: 1) The serum creatinine concentration increases and the endogenous creatinine clearance decreases significantly as the interstitium of both the cortex and the outer stripe of the outer medulla increases in width. 2) The urine osmolality decreases significantly as the epithelial areas of the proximal tubules and ascending limbs of Henle's loop decrease, and as the serum creatinine concentration rises and the areas of the interstitium increase. 3) No significant correlation exists between the percentage of hyalinized glomeruli and the urine osmolality. 4) The total area of the intertubular capillaries in the cortex decreases significantly as the interstitium in this area increases in width and as the serum creatinine concentration increases. 5) Compensatory hypertrophy of individual nephrons, as proposed by Bricker's hypothesis, was found only where more than 90% of the glomeruli were hyalinized.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在63个肾活检标本中测量了以下参数,其中大多数表现为系膜增生性肾小球肾炎:皮质和外髓质外带间质的相对面积、毛细血管面积,以及近端小管和髓袢升支上皮的面积。还测定了玻璃样变肾小球的百分比。对这些值与肾功能参数之间的相关性进行研究后发现如下情况:1)随着皮质和外髓质外带的间质宽度增加,血清肌酐浓度升高,内生肌酐清除率显著降低。2)随着近端小管和髓袢升支上皮面积减少,以及血清肌酐浓度升高和间质面积增加,尿渗透压显著降低。3)玻璃样变肾小球的百分比与尿渗透压之间无显著相关性。4)随着该区域间质宽度增加和血清肌酐浓度升高,皮质肾小管周围毛细血管的总面积显著减少。5)仅在超过90%的肾小球发生玻璃样变的情况下,才发现了如布里克假说所提出的单个肾单位的代偿性肥大。(摘要截短于250词)

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