CAJ | 학술논문

目的了解成年人肾小球基底膜(GBM)厚度及拟建议薄基底膜肾病(TBMN)的GBM弥漫变薄的标准.方法选取肾癌根治性切除患者29例,分析性别、年龄、尿常规、Scr以及既往史、家族史等临床资料.选取远离病灶的肾皮质组织,进行光镜、免疫荧光及透射电镜检查,并进行GBM厚度测量和Ⅳ型胶原α3、α5链免疫荧光检查.结果 29例中,男15例、女14例,年龄(55.9±14.9)岁(20～80岁),所有病例均无肾脏病家族史.肾组织GBM厚度为(363.6±46.8)nm.GBM厚度与性别相关,男性为(384.0±41.7)nm,女性为(335.0±39.2)nm,差异有统计学意义(P=0.008).建议以均数减去两倍标准差作为GBM变薄的标准,即GBM厚度＜270 nm.结论成年人肾组织的GBM厚度为(363.6±46.8)nm.GBM厚度和性别相关,男性GBM厚度大于女性,差异有统计学意义.TBMN的GBM弥漫变薄的诊断标准建议为GBM厚度＜270 nm,也建议今后制定TBMN标准中应考虑男女的差异.
목적 료해성년인신소구기저막(GBM)후도급의건의박기저막신병(TBMN)적GBM미만변박적표준.방법 선취신암근치성절제환자29례,분석성별、년령、뇨상규、Scr이급기왕사、가족사등림상자료.선취원리병조적신피질조직,진행광경、면역형광급투사전경검사,병진행GBM후도측량화Ⅳ형효원α3、α5련면역형광검사.결과 29례중,남15례、녀14례,년령(55.9±14.9)세(20～80세),소유병례균무신장병가족사.신조직GBM후도위(363.6±46.8)nm.GBM후도여성별상관,남성위(384.0±41.7)nm,녀성위(335.0±39.2)nm,차이유통계학의의(P=0.008).건의이균수감거량배표준차작위GBM변박적표준,즉GBM후도＜270 nm.결론 성년인신조직적GBM후도위(363.6±46.8)nm.GBM후도화성별상관,남성GBM후도대우녀성,차이유통계학의의.TBMN적GBM미만변박적진단표준건의위GBM후도＜270 nm,야건의금후제정TBMN표준중응고필남녀적차이.
Objective To elucidate the thickness of glomerular basement membrane (CBM) in adult kidney tissue and to establish the standard of GBM thickness for thin basement membrane nephropathy (TBMN) in China. Methods Kidney cortex tissue samples apart from cancer focus were collected from 29 patients undergoing nephrectomy. Clinical data of patients were analyzed. Light, immunofluorescence and electron microscope examinations were performed on these 29 samples to measure the thickness of GBM and the distribution of collagen Ⅳα3, α5 chains. Results There were fifteen male and fourteen female cases with age (55.9±14.9) (20-80) years old. No familial history of renal disease or other diseases was found in these cases. The CBM thickness of these samples was (363.6 ±46.8) nm, which was associated with gender. GBM thickness was (384.0±41.7) nm in male, and (335.0±39.2) nm in female, which was significantly different (P=0.008). The standard to diagnose thin GBM should be the mean minus double standard deviation. So the standard of GBM thickness for TBMN should be <270 nm. Conclusions The GBM thickness of adults is (363.6±46.8) nm. GBM thickness is associated with gender, which is thicker in males with significant difference. It is suggested that the standard of GBM thickness for TBMN in adult should be <270 nm, and the difference of GBM thickness between male and female should be considered too.