摘要
目的:探讨脂蛋白肾病(lipoproteinglomerulopathy,LPG)患者的临床表现与病理学特征(组织学、免疫组织化学、超微结构特征)。方法:5例患者经肾活检病理与免疫病理证实为脂蛋白肾病,回顾性分析这5例脂蛋白肾病患者的临床表现、实验室检查结果,并通过肾活检分析其组织学、免疫组织化学与超微结构特点。结果:所有患者均有大量蛋白尿与镜下血尿;血清总胆固醇正常或轻度增高,但是甘油三酯与ApoB、ApoE水平显著上升;肾活检组织光镜下肾小球体积明显增大,毛细血管袢高度扩张,袢内充满大量大小不一淡染物质,呈网眼样,不嗜银,可见巨大“栓子”。免疫荧光染色证实“栓子”富含ApoB、ApoE。结论:脂蛋白肾病患者的临床表现多样,诊断脂蛋白肾病应结合临床表现与肾活检后病理学特征,其中毛细血管袢内脂蛋白栓子、ApoB、ApoE染色阳性是诊断关键。
Objective： To investigate the clinical manifestations and pathological characteristics of lipoprotein nephropathy （LPN）. Methods： Five cases were diagnosed LPN by renal biopsy. Data of five LPN patients were reviewed retrospectively, including clinical manifestations and laboratory examinations （biochemical profiles and plasma ooneentration of Apo B and Apo E）. Biopsy specimens were processed by light microscopy, immunohistochenaistry staining and electron microscopy, Results：All patients were found having proteinuria and microscopic hematuria. The levels of triglyceride were elevated lightly, and those of Apo B and Apo E were elevated markedly, In all cases, inerernents of glomerular size and lipoprotein thrombi that occupied capillary lumica in the glomeruli were observed. Immuohistochemistry staining showed that the thrornbi were strongly positive for Apo B and Apo E. Granules and various sizes of vacuoles in the thrornbi were observed under electronic microscopy. Conclusion：Diagnosis of LPN should be based on clinical manifestations and renal biopsy. Extensive glomerular capillary thrornbi stained positive for Apo B and Apo E , which play a key role in the diagnosis of LPN.
出处
《中国中西医结合肾病杂志》
2005年第8期463-465,共3页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
广东省中医药科研基金资助项目(No.1040171)
