Ye R G, Mao X L
Kidney Research Institute, Sun Yat-sen University of Medical Sciences, Guangzhou.
Zhonghua Nei Ke Za Zhi. 1994 Feb;33(2):77-9.
We developed an in vitro model to produce urinary dysmorphic RBCs and to investigate the influence of pH and osmolality. The pH and osmolality of the RBCs suspension was made to change systematically within a range of pH 5-8 and 200-800 mOsm/kg, and at a flow rate of 0.5 ml/min through a polycarbonate filter (Calif., USA) with pore diameter of 3 mu. Then the samples were examined with phase-contrast microscopy. Our data showed that: (1) The formation of glomerular RBCs depends on their passage through a narrow pore and the presence of certain suspension, which is also present in glomerulonephritis. Suspension of RBCs in urine with the same osmolality and pH, but without filtration did not produce glomerular shapes. (2) Urine facilitated the production of glomerular shapes. Filtration of RBCs suspension in physiological buffer instead of urine produce less dysmorphic shapes than filtration in urine of various pH and osmolality. (3) Certain types of urinary RBCs shapes occurring predominantly at specific conditions of pH and osmolality (< 400 mOsm/kg) produced glomerular shapes most frequently, e.g. doughnut-like RBCs were produced by urine with pH 7. Our data suggested that the mechanism of glomerular RBCs formation might result from the passage of RBCs through narrow defects in the ruptured glomerular capillary wall and a chemical injury to the RBCs in the tubular lumen induced by urinary constituents.
我们建立了一个体外模型来产生尿异形红细胞，并研究pH值和渗透压的影响。将红细胞悬液的pH值和渗透压在pH 5 - 8和200 - 800 mOsm/kg范围内进行系统改变，并以0.5 ml/min的流速通过孔径为3μm的聚碳酸酯滤膜（美国加利福尼亚州）。然后用相差显微镜检查样本。我们的数据表明：（1）肾小球性红细胞的形成取决于它们通过狭窄孔隙以及存在特定的悬液，这在肾小球肾炎中也存在。将红细胞悬液置于具有相同渗透压和pH值但未经过滤的尿液中不会产生肾小球样形态。（2）尿液促进了肾小球样形态的产生。在生理缓冲液中而非尿液中过滤红细胞悬液所产生的异形形态比在不同pH值和渗透压的尿液中过滤产生的要少。（3）某些类型的尿红细胞形态主要在特定的pH值和渗透压条件（<400 mOsm/kg）下出现，最常产生肾小球样形态，例如pH 7的尿液会产生甜甜圈样红细胞。我们的数据表明，肾小球性红细胞形成的机制可能是红细胞通过破裂的肾小球毛细血管壁上的狭窄缺陷以及肾小管腔中尿成分对红细胞造成化学损伤所致。
