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[慢性肾小球肾炎不同形态类型及阶段中肾小球滤过膜对中、高分子血清蛋白的通透性紊乱]

[Disordered permeability of the glomerular filter for middle- and high-molecular serum proteins in various morphologic types and stages of chronic glomerulonephritis].

作者信息

Ratner M Ia, Fedorova N D

出版信息

Ter Arkh. 1988;60(11):112-6.

PMID:3238561
Abstract

Investigation of glomerular filter permeability for serum immunoglobulins and albumins in 83 patients with chronic glomerulonephritis (CGN) with nephrotic proteinuria has shown that in mesangioproliferative glomerulonephritis permeability for IgM is rare, for IgA and IgG moderately raised; in a marked but not maximum degree of permeability for albumins, it is characterized by considerable variability. In maximum permeability for albumins there is a tendency to the reduction of the ratio of IgA and IgM clearances to albumin clearance, and variability of these indices. In membranous CGN the structure of nephron permeability for serum proteins is identical but it remains unchanged with a sharp rise of albumin fractional clearance. In mesangiocapillary CGN permeability for IgM is more frequent and enhanced for IgG. in focal-segmental glomerular hyalinosis/sclerosis and diffuse-fibroplastic GN permeability for IgG is considerably raised unrelated to a degree of permeability for albumins. Sclerotic changes are accompanied by elevated permeability for IgG.

摘要

对83例患有肾病性蛋白尿的慢性肾小球肾炎(CGN)患者的肾小球滤过膜对血清免疫球蛋白和白蛋白的通透性进行研究,结果显示:在系膜增生性肾小球肾炎中,IgM的通透性罕见,IgA和IgG的通透性中度升高;白蛋白的通透性处于显著但未达到最高程度时,其特征是变异性较大。在白蛋白通透性最高时,IgA和IgM清除率与白蛋白清除率的比值有降低趋势,且这些指标存在变异性。在膜性CGN中,肾单位对血清蛋白的通透性结构相同,但随着白蛋白分数清除率急剧升高,该结构保持不变。在系膜毛细血管性CGN中,IgM的通透性更常见,IgG的通透性增强。在局灶节段性肾小球硬化症/硬化和弥漫性纤维增生性肾小球肾炎中,IgG的通透性显著升高,与白蛋白的通透性程度无关。硬化性改变伴有IgG通透性升高。

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