EHF肾组织肾小球超微结构和细胞表型的研究

研究流行性出血热 ( EHF)肾组织中肾小球超微结构和细胞表型的改变及其意义。方法　应用多重 PAP法研究 30例 EHF肾组织中肾小球α-平滑肌肌动蛋白 (α- SMA)、结蛋白 ( desmin)和增殖细胞核抗原 ( PCNA)的表达及意义 ;应用电子显微镜观察肾小球的超微结构。结果　 EHF肾脏仅 4例肾小球显示痕量的 α- SMA阳性表达 ,无 desmin和 PCNA的表达。电镜下观察肾小球毛细血管内皮细胞不同程度肿胀。部分少尿期病例的个别肾小球见毛细血管内皮细胞坏死 ,管腔内有嗜中性粒细胞及血小板 ,内皮细胞与基底膜间充以低电子密度的物质。结论　 EHF肾组织中肾小球主要表现毛细血管内皮细胞超微结构的改变 ,而系膜细胞和上皮细胞仅表现不同程度的增生 ,肾小球无明显细胞表型的转化。作为全身毛细血管的一部分 ,肾小球毛细血管内皮细胞的损伤 ,可能在 EHF急性肾衰发病机理的研究中具有重要的意义

Ultrastructure and phenotypic changes at glomeruli in renal tissue from the patients with epidemic hemorrhagic fever

Objective To study changes and significances of ultrastructure and phenotypic at glomeruli in renal tissue from the patients with epidemic hemorrhagic fever.Methods Using immunohistochemical(PAP) method ,this research studies the expression and significance of α smooth muscle actin(α SMA),desmin and proliferating cell nuclear antigen(PCNA) at glomeruli and observes the changes of glomerular ultrastructure under electron microscopy in 30 patients with epidemic hemorrhagic fever.Results There was only a trace mesangial staning of α SMA in 4 of 30 cases EHF, but there were no staining of desmin and PCNA.Under electron microscopy, glomerular endothelial cells were differently swollen.In oilurine stage, some cases showed that there were focal necrosis of glomerular endothelial cells and low electron density located between edothelial cell and basement membrane.The lumina of glomeruli was narrowed by leukocytes and aggregates of platelets.Conclusion The results suggest that glomerular ultrastructure shows prominently the injury of endothelial cells in renal tissue from the patients with EHF.And the mesagial and epithelial cells appear slight or modest enlargement without phenotypic changes.It may be of great significance to study glomerular lesions during exploring the mechanisms of acute renal failure in EHF.