Tyagi I, Agrawal U, Amitabh V, Jain A K, Saxena S
Indian J Nephrol. 2008 Apr;18(2):64-9. doi: 10.4103/0971-4065.42336.
This study aimed to elucidate the early renal changes in diabetes mellitus (DM) with and without clinical symptoms related to renal damage.
Renal biopsy was studied in 25 patients (14 with microalbuminuria and 11 with albuminuria) both by light and electron microscopies (LM and EM, respectively) for renal changes and morphometry was performed to study glomerular and tubular basement membranes (GBM and TBM, respectively) width using a Soft Imaging System GmBH (analysis 3).
A significant increase was noted in the mean GBM and TBM thickness in both the preclinical and clinical groups compared to the control group. The changes in the TBM were noted to be predominant in both preclinical and clinical patients.
This study indicates the importance of morphometric evaluation of the GBM and TBM width in the elucidation of early renal damage in diabetic nephropathy, especially in the absence of LM changes. The significance of identification of early renal changes using morphometric techniques for better management of these patients requires further studies.
本研究旨在阐明有和无肾损伤相关临床症状的糖尿病（DM）患者的早期肾脏变化。
对25例患者（14例微量白蛋白尿患者和11例白蛋白尿患者）进行肾活检，分别通过光学显微镜和电子显微镜（分别为LM和EM）观察肾脏变化，并使用Soft Imaging System GmBH（分析3）进行形态计量学研究，以分别测量肾小球和肾小管基底膜（GBM和TBM）的宽度。
与对照组相比，临床前期和临床组的平均GBM和TBM厚度均显著增加。临床前期和临床患者的TBM变化均较为明显。
本研究表明，在阐明糖尿病肾病早期肾损伤，尤其是在无LM变化的情况下，对GBM和TBM宽度进行形态计量学评估具有重要意义。使用形态计量学技术识别早期肾脏变化对这些患者进行更好管理的意义，还需要进一步研究。
