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目的 观察细胞增殖与凋亡在膜增生性肾小球肾炎(MPGN)、弥漫增生性狼疮性肾炎(LN)和急性感染后肾炎(APGN)的表现。方法 用原位末端标记方法对12例MPGN,15例LN和13例APGN患者肾活检组织中肾小球内凋亡细胞进行了观察,并用免疫组化方法同时对增殖细胞(PCNA染色阳性细胞)进行了分析。结果 在肾小球细胞增殖的同时,MPGN和LN患者表现出明显的凋亡不足的征象,而APGN患者则伴活跃的细胞凋亡。凋亡细胞数在APGN明显大于MPGN和LN,而增殖细胞与凋亡细胞的比值则以MPGN最大。结论 不同的增生性肾炎由于病因和病变性质不同,虽然都表现出细胞增殖,但其凋亡机制的反应性存在着明显的差异,这可能是上述三种增生性肾炎预后不同的因素之一。
Objective To observe the expression of cell proliferation and apoptosis in membranoproliferative glomerulonephritis (MPGN), diffuse proliferative lupus nephritis (LN) and acute postinfection glomerulonephritis (APGN). Methods Apoptotic cells in renal glomerulus of 12 cases of MPGN, 15 cases of LN and 13 cases of APGN were observed by in situ end-labeling. The proliferating cells (PCNA-positive cells) Analyzed. Results While glomerular cells proliferated, MPGN and LN showed marked signs of under-apoptosis, whereas patients with APGN had active apoptosis. The number of apoptotic cells in APGN was significantly greater than that of MPGN and LN, while the ratio of proliferating cells to apoptotic cells was the largest in MPGN. Conclusions Different proliferative glomerulonephritis, although different in etiology and pathology, showed cell proliferation, but there was significant difference in the reactivity of apoptosis mechanism, which may be one of the different prognostic factors of the above three proliferative glomerulonephritis.