Pound S E, MacDonald M K, Thomson D
Department of Pathology, Edinburgh University Medical School, UK.
Histopathology. 1987 Mar;11(3):227-43. doi: 10.1111/j.1365-2559.1987.tb02629.x.
Fifty-four biopsies of diffuse proliferative glomerulonephritis were subdivided into two groups, diffuse endocapillary proliferative glomerulonephritis (DEPGN) and mesangial proliferative glomerulonephritis (MPGN) according to current morphological criteria. The two groups were then compared by light microscopy, cell counting techniques, electron microscopy, immunofluorescence or immunoperoxidase techniques, and a clinical survey. The results show that DEPGN differs from MPGN in only three points: (1) the former has a greater degree of mesangial proliferation, (2) the former has a less favourable short-term prognosis and (3) large subepithelial deposits (humps) are much more common in DEPGN than in MGPN (in this series no MPGN cases showed such deposits), while small dark deposits are present in or on the glomerular capillary basement membrane in more cases of MPGN than of DEPGN. It is proposed that biopsies showing diffuse proliferation of mesangial cells should be classified as diffuse proliferative glomerulonephritis of a mild, moderate or severe degree, as the current classification has been interpreted as implying separate aetiologies and suggests that these are two distinct disease entities.
根据当前的形态学标准，将54例弥漫性增生性肾小球肾炎活检标本分为两组，即弥漫性毛细血管内增生性肾小球肾炎（DEPGN）和系膜增生性肾小球肾炎（MPGN）。然后通过光学显微镜、细胞计数技术、电子显微镜、免疫荧光或免疫过氧化物酶技术以及临床调查对这两组进行比较。结果显示，DEPGN与MPGN仅在三点上存在差异：（1）前者系膜增生程度更高；（2）前者短期预后较差；（3）DEPGN中大量上皮下沉积物（驼峰）比MPGN常见得多（在本系列中，无MPGN病例显示有此类沉积物），而MPGN比DEPGN更多病例的肾小球毛细血管基底膜内或其上存在小的深色沉积物。有人提出，显示系膜细胞弥漫性增生的活检标本应分为轻度、中度或重度弥漫性增生性肾小球肾炎，因为目前的分类被解释为意味着病因不同，并表明这是两种不同的疾病实体。
