Ueno M, Nishi S, Arakawa M
Department of Medicine(II), Niigata University School of Medicine.
Nihon Rinsho. 1995 Aug;53(8):1981-7.
Recently, the tubulo-interstitial lesions in diabetes mellitus (DM) have become of greater interest, as well as, glomerulosclerosis. From the view points of tubular function, a variety of changes, including tubular proteinuria and transport of sodium, glucose, and divalent ions have been known until the present time, although the details remain to be elucidated. Morphologically the interstitial fibrosis and the thickening of tubular basement membrane were pointed out to be important features in incipient or overt diabetic nephropathy of insulin-dependent DM patients. We found the expansion of interstitium even in the area without hyalinized glomeruli and atrophic tubules in normo- and microalbuminuric non-insulin dependent DM patients by semiquantitative evaluation of biopsy specimens. Further studies of the mechanisms will be necessary to clarify the mechanism of the development of diabetic nephropathy.
近年来，糖尿病（DM）中的肾小管间质病变以及肾小球硬化越来越受到关注。从肾小管功能的角度来看，尽管细节仍有待阐明，但目前已知包括肾小管蛋白尿以及钠、葡萄糖和二价离子转运在内的各种变化。在形态学上，间质纤维化和肾小管基底膜增厚被指出是胰岛素依赖型糖尿病患者早期或显性糖尿病肾病的重要特征。通过对活检标本的半定量评估，我们发现正常白蛋白尿和微量白蛋白尿的非胰岛素依赖型糖尿病患者即使在没有肾小球玻璃样变和肾小管萎缩的区域也存在间质扩张。有必要对这些机制进行进一步研究以阐明糖尿病肾病的发病机制。
