Seefeldt T, Bohman S O, Jørgen H, Gundersen H J, Maunsbach A B, Petersen V P, Olsen S
Lab Invest. 1981 Jun;44(6):541-6.
The relationship between foot process fusion (retraction) and proteinuria in glomerular diseases has been known for many years, but only a few quantitative studies have been performed. The quantitative morphometrical method used here makes it possible to estimate the distribution of true foot process width from the observed apparent width on electron micrographs. The true foot process width was analyzed in a consecutive material of patients with glomerulonephritis and related to the diurnal urinary protein excretion. Only a weak correlation was found between these two parameters. Albeit an abnormal foot process width was invariably associated with proteinuria, a rather large fraction of patients with gross proteinuria had normal foot process width compared to control subjects. Thus, if foot process fusion causes proteinuria, this can not be the only mechanism leading to this permeability alteration. On the other hand, our results show that foot process fusion is not a necessary consequence of proteinuria. In addition, a methodologic study was performed, analyzing the relationship between the quantitative and a semiquantitative method for estimating foot process fusion. It is concluded that the latter method is fast and sufficiently precise for most evaluations of foot process width in human kidney biopsies.
肾小球疾病中足突融合（退缩）与蛋白尿之间的关系已为人所知多年，但仅有少数定量研究。本文所采用的定量形态测量方法能够根据电子显微镜照片上观察到的表观宽度估算真实足突宽度的分布情况。对一系列肾小球肾炎患者的材料进行了真实足突宽度分析，并将其与日间尿蛋白排泄量相关联。这两个参数之间仅发现微弱的相关性。尽管异常的足突宽度总是与蛋白尿相关，但与对照组相比，相当一部分大量蛋白尿患者的足突宽度正常。因此，如果足突融合导致蛋白尿，这不可能是导致这种通透性改变的唯一机制。另一方面，我们的结果表明足突融合并非蛋白尿的必然结果。此外，还进行了一项方法学研究，分析了评估足突融合的定量方法与半定量方法之间的关系。得出的结论是，后一种方法快速且对于大多数人肾活检中足突宽度的评估足够精确。
