CAJ | 학술논문

目的研究胎羊单侧输尿管不完全性梗阻后肾脏的组织学改变,探讨梗阻性肾病的发生机制.方法以16只胎羊为研究对象.实验分两组:①梗阻组,对12只孕75～85 d的胎羊实行宫内手术,F6 C形硅胶环环套在胎羊一侧输尿管上段以造成输尿管不完全性梗阻;②对照组,对4只胎羊实行宫内手术但不结扎输尿管.待胎羊出生后,取其肾脏标本检测病理改变,足细胞表型转化以及配对盒基因2(PAX2)和VEGF的表达变化.结果梗阻组12只胎羊,其中9只顺利生产;对照组4只胎羊,均顺利生产.与对照组羔羊肾脏相比,梗阻组羔羊梗阻侧肾脏,表现为皮质囊性改变,间质纤维化,肾小球数目显著减少;足细胞足突广泛融合[(4.20±1.08)%比(86.79±1.66)%];PAX2表达显著升高(1.43±0.09比2.44±0.09);而VEGF表达明显减少(0.80±0.15比0.33±0.14).结论在胎羊模型中,通过观察单侧输尿管不完全性梗阻后肾脏的组织学改变,说明足细胞表型转化以及PAX2和VEGF表达的变化可能在梗阻所致的肾脏损伤性改变中占有重要作用.
목적 연구태양단측수뇨관불완전성경조후신장적조직학개변,탐토경조성신병적발생궤제.방법 이16지태양위연구대상.실험분량조:①경조조,대12지잉75～85 d적태양실행궁내수술,F6 C형규효배배투재태양일측수뇨관상단이조성수뇨관불완전성경조;②대조조,대4지태양실행궁내수술단불결찰수뇨관.대태양출생후,취기신장표본검측병리개변,족세포표형전화이급배대합기인2(PAX2)화VEGF적표체변화.결과 경조조12지태양,기중9지순리생산;대조조4지태양,균순리생산.여대조조고양신장상비,경조조고양경조측신장,표현위피질낭성개변,간질섬유화,신소구수목현저감소;족세포족돌엄범융합[(4.20±1.08)%비(86.79±1.66)%];PAX2표체현저승고(1.43±0.09비2.44±0.09);이VEGF표체명현감소(0.80±0.15비0.33±0.14).결론 재태양모형중,통과관찰단측수뇨관불완전성경조후신장적조직학개변,설명족세포표형전화이급PAX2화VEGF표체적변화가능재경조소치적신장손상성개변중점유중요작용.
Objective To investigate the phenotypic change of the podocytes and paired box gene 2 (PAX2) and vascular endothelial growth factor (VEGF) expressions in fetal lambs' kidneys with unilateral partial ureteral obstruction. Methods Sixteen fetal lambs were randomly assigned to the obstruction and control group. The obstruction group included 12 lambs, whose superior segment ureters were tied with splited silastic tube to induce unilateral partial ureteral obstruction between 75and 85 gestational days. The control group had 4 fetal lambs subjected to sham operation. After birth,the kidneys of the lambs were harvested to study the phenotypic change of the podocytes as well as expressions of PAX2 and VEGF in the kidneys. Results Nine out of the 12 lambs of the obstruction group were delivered alive. All 4 sham operated lambs were delivered alive. Renal cortex cysts of varying sizes, interstitial fibrosis, a decrease in glomeruli number, and severe podocyte foot process fusion (4. 20± 1.08% vs 86. 79 ± 1.66%) were found in the obstructed kidneys compared with the control kidneys. The PAX2 expression in obstructed kidneys was significantly higher than that of the control kidneys (1.43 ± 0. 09 vs 2. 44 ± 0. 09, P＜0. 05). The VEGF expression was significantly decreased compared with the control kidneys (0. 80 ± 0. 15 vs 0. 33 ± 0. 14, P＜0. 05). Conclusions The changes of the phenotype and PAX2 and VEGF expressions may play roles in the pathogenesis of obstructive nephropathy.