移植肾中强折光性结晶体的形态计量

The morphometry of strongly polarible crystals in kidney allografts

  • 摘要: 目的:探讨移植肾中出现强折光性结晶体的病理学意义。方法:在带有微标尺的偏光显微镜下对90例手术切除的人类同种移植肾进行了形态计量研究。结果:强折光性结晶体的检出率为57.8%(52/90);平均每10个高倍视野的数量为12个;大小为8~80μm。急性排斥肾脏中结晶体的检出率为95.7%(22/23);慢性排异时检出率为77.8%(21/27);2例超急排异移植肾及术前供肾组织中均未见强折光性结晶体;其它并发症时检出率为25%(9/36)。强折光性结晶体见于肾曲小管腔内及上皮细胞内,伴有上皮的萎缩、炎症或坏死。结论:强折光性结晶体是移植肾功能,尤其是肾曲小管排泌功能受损的产物,具有病理学意义

     

    Abstract: Objective: To reveal the pathologic significancy of strongly polarible crystals in kidney allografts.Methods:90 surgically removed kidney allografts were morphometrically observed under polarized light microscope with a fixed microrula. Results:The crystals were detected in 52 renal allografts with the positive rate of 57.8%. The average number was of 12 per 10 high power fields (HPF) with the size of 8-80μm in great diameter. 22 of 23 allografts of acute rejection and 21 of 27 allografts of chronic rejection showed the crystals (95.7% and 77.8%, respectively). But there were no crystals detected in 2 allografts of hyperacute rejection and in donor boipsies. Only 9 of 36 grafts failed of other complications such as infection, acute tubular necrosis were positive for crystals. The strongly polarible crystals were located in tubular lumens and within the cytoplasm of tubular epithelia, usually accompanied bytubular atrophy, necrosis and tubulitis.Conclusion:The deposition of polarible crystals are morphologic evidence of the failure of transplanted kidneys and may be associated with the functional insufficiency of tubular epithelia.

     

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