Tirapelli L F, Barione D F, Trazzi B F M, Tirapelli D P C, Novas P C, Silva C S, Martinez M, Costa R S, Tucci S, Suaid H J, Cologna A J, Martins A C P
Department of Surgery and Anatomy, Medical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900--CEP 14049-900, Ribeirão Preto, São Paulo, Brazil.
Transplant Proc. 2009 Dec;41(10):4083-7. doi: 10.1016/j.transproceed.2009.09.061.
Renal ischemia/reperfusion (I/R) injury is one of the frequent causes of acute renal failure (ARF) due to the complex, interrelated sequence of events, that result in damage to and death of kidney cells. Cells of the proximal tubular epithelium are especially susceptible to I/R injury, leading to acute tubular necrosis, which plays a pivotal role in the pathogenesis of ARF. Several models have been explicated to assess morphological changes, including those of Jabonski et al. and Goujon et al. We compared the 2 models for histopathological evaluation of 30- or 120-minute periods of renal ischemia followed by 24-hour reperfusion in rats. Several changes were observed after application of the 2 models: proximal tubular cell necrosis, loss of brush border, vacuolization, denudation of tubular basement membrane as a consequence of flattening of basal cells, and presence of intratubular exfoliated cells in the lumen of proximal convoluted tubules at various stages of degeneration (karyorexis, kariopyknosis and karyolysis). Evaluating tubular lesions after 2 periods of experimental ischemia with light microscopy allowed us to conclude that the Goujon classification better characterized the main changes in cortical renal tubules after ischemia.
肾缺血/再灌注（I/R）损伤是急性肾衰竭（ARF）的常见病因之一，这是由于一系列复杂且相互关联的事件导致肾细胞受损和死亡。近端肾小管上皮细胞尤其易受I/R损伤，进而导致急性肾小管坏死，这在ARF的发病机制中起关键作用。已经阐述了几种模型来评估形态学变化，包括雅邦斯基等人和古琼等人的模型。我们比较了这两种模型，用于对大鼠肾缺血30分钟或120分钟后再灌注24小时的组织病理学评估。应用这两种模型后观察到了一些变化：近端肾小管细胞坏死、刷状缘丧失、空泡化、由于基底细胞扁平化导致的肾小管基底膜剥脱，以及在近端曲管腔中不同变性阶段（核碎裂、核固缩和核溶解）存在肾小管内脱落细胞。用光镜评估两个实验性缺血期后的肾小管病变，使我们得出结论，古琼分类能更好地描述缺血后肾皮质肾小管的主要变化。
