二维平面足细胞相对密度测量法  

Two-Dimensional Measurement of the Relative Density of Podocytes

作　　者：安宁[1] 杨陈[1] 陶静莉[1] 李尚妹[1] 陈华青[1] 陈孝文[1] 梁东[1] 刘华锋[1] 

机构地区：[1]广东医学院附属医院肾病研究所,湛江524001

出　　处：《中国中西医结合肾病杂志》2010年第4期291-294,I0001,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：广东省自然科学基金资助项目(No.7009939);广东省科技计划项目(No.2008B030301022)

摘　　要：目的:探索一种简便且临床实用的足细胞丢失评估方法。方法:应用免疫组化法对正常和阿霉素肾病大鼠的肾组织,以及正常肾组织和3种不同病理类型肾小球疾病患者肾组织进行Wilms′瘤蛋白免疫染色,采用手工计数和病理图像分析技术相结合的方法分别对单个肾小球内足细胞的绝对数以及单位面积肾小球内足细胞的相对密度进行测定,找出结果可靠的最低肾小球数目并检验不同测量人员所获结果的一致性。结果:在统计10个和15个大鼠肾小球时,阿霉素肾病组肾小球足细胞相对密度显著低于正常大鼠;无论统计的肾小球数目多少,两组大鼠肾小球足细胞绝对数差异无统计学意义。在统计5个和10个人类肾小球时,局灶节段性肾小球硬化组和膜性肾病组肾小球足细胞相对密度均显著低于正常组和微小病变组;局灶节段性肾小球硬化组肾小球足细胞绝对数显著低于正常组和微小病变组。人类肾小球足细胞相对密度与血肌酐(Scr)水平呈低度负相关,但与24h尿蛋白含量(24hUPQ)无相关关系;阿霉素肾病大鼠肾小球足细胞相对密度与Scr、24hUPQ无相关关系。两名检测者所获结果有高度一致性。结论:这种足细胞相对密度评估法简便、快捷和可靠,且所需肾小球数目少,有望在临床实践中推广。Objective：To develop a convenient and practical method of podocyte loss evaluation for clinical practice.Methods：Podocytes were identified by specific immunohistological staining of Wilms tumor protein 1（WT1）in rat renal tissues from Adriamycin-induced nephropathy models（NEP）and its controls（CON）,as well as in human renal tissues of different glomerulonephritis and its normal controls.Then the podocyte density was evaluated by manual counting and pathological image analysis.Finally the consistency of the results measured by different pathologists was tested.Results：The podocyte density was of no significant difference between NEP group and CON group when only 5 rats glomeruli were evaluated,while the podocyte density in NEP group was significantly lower than that in CON group when 10 or 15 rats glomeruli were evaluated.Regardless of the number of the rats renal glomeruli evaluated,no significant difference was found between the two groups in podocyte number per glomerulus.The podocyte density in patients with focal segmental glomerulosclerosis（FSGS）and memberanous nephropathy（MN）were significantly lower than those in normal controls and in patients with minimal change nephropathy（MCD）when 5 or 10 glomeruli were evaluated,and the results were of no statistic significance no matter 5 or 10 glomeruli were evaulated.The podocyte number per glomerulus in patients with FSGS was significantly lower than those in the normal group and in patients with MCD.Podocyte density in renal diseases patients had a low degree of negative correlation with levels of serum creatinine,but it had no relationship with 24 hours urine protein quantitation（24 h UPQ）.No significant correlation was found between the podocyte number per glomerulus and Scr or 24 h UPQ in NEP rats.Furthermore,the measuring results from two renal pathologists were highly coincident.Conclusion：Podocyte density measurement introduced in the present study may be a simple,convenient and practical method on podocyte loss evaluation.

关 键 词：足细胞 丢失 评估 

分 类 号：R692[医药卫生—泌尿科学]