Kobayashi M, Koyama A, Yamagata K, Yamaguchi N, Narita M, Shigematsu H
Department of Internal Medicine, University of Tsukuba, Japan.
Nihon Jinzo Gakkai Shi. 1992 Jan;34(1):47-56.
The glomerular injuries in 129 cases of IgA nephropathy (IgA-N) were examined ultrastructurally with special reference to the glomerular basement membrane (GBM) deposits and capillary loop abnormalities, and the correlation between these findings and the clinicopathological data was analyzed. The following results were obtained. 1) The degree of daily excretion of urine protein (UP) and creatinine clearance (Ccr) revealed a significant correlation with the degree of mesangial hypercellularities and the frequency of segmental lesions. 2) All sites of GBM deposits, and discontinuity and/or splitting among the GBM abnormalities showed a significant relation to the severity of proliferation and segmental lesions. 3) The GBM deposits, discontinuity and splitting showed a significant relation to the degree of UP and Ccr. We speculate therefore that capillary loop deposits and/or capillary loop discontinuity and splitting could represent histological prognostic factors for an unfavorable outcome in IgA nephropathy.
对129例IgA肾病（IgA-N）患者的肾小球损伤进行了超微结构检查，特别关注肾小球基底膜（GBM）沉积物和毛细血管袢异常，并分析了这些发现与临床病理数据之间的相关性。获得了以下结果。1）尿蛋白（UP）每日排泄量和肌酐清除率（Ccr）与系膜细胞增多程度和节段性病变频率呈显著相关。2）GBM沉积物的所有部位，以及GBM异常中的连续性中断和/或分裂与增殖和节段性病变的严重程度呈显著相关。3）GBM沉积物、连续性中断和分裂与UP和Ccr程度呈显著相关。因此，我们推测毛细血管袢沉积物和/或毛细血管袢连续性中断和分裂可能是IgA肾病不良预后的组织学预测因素。
