目的建立大鼠微小病变型肾病综合征模型,观察低分子右旋糖酐对肾病综合征水肿状态时肾小球基底膜足突形态的影响。方法采用连续式静脉输液法给药。标本用透射电镜观察,通过体视学方法比较正常组、模型组、盐水组(生理盐水+速尿)与右糖组(低分子右旋糖酐+速尿)肾小球基底膜足突形态的变化。结果正常组足突呈细长的指状突起,相邻足突之间的间隙及裂孔隔膜清楚可见;模型组足突广泛融合,足突间隙及裂孔隔膜消失;盐水组足突绝大部分处于融合状态,小部分虽未融合但仍处于明显肿胀的状态;右糖组足突肿胀明显减轻,表现为足突局段融合、局段肿胀与局段完全恢复正常混同存在的现象,多数足突间隙逐渐显现,有些甚至可清楚的看到裂孔隔膜。体视学形态计量结果表明,正常组与模型组,正常组与盐水组,右糖组与模型组,右糖组与盐水组这4对配组间体积密度、面密度及比表面均有显著差异或高度差异(P<0.05 or P<0.01);而右糖组与正常组、模型组与盐水组之间体积密度、面密度无差异(P>0.05),比表面有显著差异(P<0.05)。结论低分子右旋糖酐应用于水肿状态的肾病综合征,可以显著减轻足突肿胀并逐渐解除其融合状态。 Objective To establish a model of minimal nephrotic syndrome in rats and observe the effect of low molecular dextran on the morphology of glomerular basement membrane foot process in edema of nephrotic syndrome. Methods Continuous intravenous infusion method. Specimens were observed by transmission electron microscopy. The changes of glomerulus foot process morphology in normal group, model group, saline group (saline + furosemide) and right sugar group (low molecular dextran + furosemide) were compared by stereological methods. Results In the normal group, there were slender finger-like protrusions in the foot process. The gap between adjacent foot processes and the septum of the hiatus were clearly visible. The model group had a wide fusion of the foot process, the foot process gap and the septal defect disappeared. Fusion state, although not a small part of the merger but still in a state of significant swelling; Right sugar group foot process swelling significantly reduced, the performance of the foot process of the local integration, local swelling and full recovery of the phenomenon of the phenomenon of partial confounding Clearance gradually appear, and some even can clearly see the hole diaphragm. Stereological morphometric results showed that there were significant differences in volume density, surface density and specific surface between the normal group and the model group, the normal group and the saline group, the right sugar group and the model group, the right sugar group and the saline group (P <0.05 or P <0.01). There was no significant difference in density of bulk density and density (P> 0.05) between the right sugar group and the normal group, the model group and the saline group (P < 0.05). Conclusion Low molecular weight dextran applied to nephrotic syndrome in edema state can significantly reduce the swelling of foot process and gradually release its fusion state.