不同刚果红染色及观察方法对肾脏淀粉样变病诊断的研究  

An Evaluation of Various Congo Red Staining and Different Microscopic Observation for the Diagnosis of Renal Amyloidosis

作　　者：董鸿瑞[1] 王艳艳[1] 杨敏[1] 孙丽君[1] 程虹[1] 谌贻璞[1] 

机构地区：[1]首都医科大学附属北京安贞医院肾内科,北京100029

出　　处：《中国中西医结合肾病杂志》2016年第11期956-958,I0001,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家科技支撑计划项目子项目(No.2011BA110B06)

摘　　要：目的:探讨诊断肾脏淀粉样变病的敏感、可靠检查法。方法:选取14例肾脏淀粉样变病肾穿刺组织标本,用7种不同的刚果红染色法进行染色,然后分别用3种显微镜进行观察。结果:7种刚果红染色法均能着染淀粉样蛋白,但是染色效果有区别,以Stokes等改良的染色法效果最佳。普通光学显微镜检查淀粉样蛋白沉积部位呈砖红色;偏振光显微镜检查仅在淀粉样蛋白沉积较多的部位见到绿色双折光,敏感性较差;荧光显微镜检查淀粉样蛋白沉积部位呈红色强荧光,敏感性远较普通光镜高。结论:采用刚果红染色法诊断肾脏淀粉样变病时,宜首选Stokes等的改良染色法。刚果红染色可用普通光学显微镜、偏振光显微镜及荧光显微镜进行观察,荧光显微镜观察的敏感性最高,值得推广。Objective： To investigate a sensitive and reliable method for diagnosis of renal amyloidosis. Methods： The renal biopsy specimens of 14 patients with renal amyloidosis were stained with 7 different Congo red staining methods,and then observed under common light microscopy（ LM）,polarized light microscopy（ PLM） and fluorescent microscopy（ FM）. Results： Seven kinds of Congo red staining all could stain amyloid,but their staining effects were various and among them the staining method modified by Stokes and colleagues had the best effect. Under LM the amyloid deposits showed brick- red color; under PLM the apple- green birefringence could be seen only in the area with many amyloid deposits,suggesting a poor sensitivity; under FM the amyloid deposits displayed a strong bright red color against a dark background,which had much higher sensitivity than LM. Conclusion： Congo red staining method was used to diagnose the renal amyloidosis,and it was better to use the method modified by Stokes and colleagues.Congo red- stained specimens could be observed by LM,PLM or FM,and among them FM has the highest sensitivity in finding amyloid deposits,so FM should be popularized and applied.

关 键 词：淀粉样变病 肾脏 刚果红染色 偏振光显微镜 荧光显微镜 

分 类 号：R692[医药卫生—泌尿科学]