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本文应用单克隆抗体和PAP四层法观察了20例原发性IgA肾病患者肾活检组织中CD_4~+、CD_8~+和B 细胞的分布。其中10例临床表现为大量蛋白尿(NP 组),另10例为反复发作性肉眼血尿(GH组)。结果发现IgA 肾病患者肾组织中CD_4~+、CD_8~+和B 细胞主要分布在间质中,肾小球内很少有淋巴细胞。NP 组和GH 组间质中CD_4、CD_8~+和B 细胞均明显高于正常对照组,其中NP 组增高更为明显。三组RT 值之间无显著差异。两组病人肾小球病变无明显不同,但NP 组间质小管病变明显重于GH 组。在NP 组还可见到间质中有较多的CD_4~+细胞聚集现象。本研究显示NP 组患者预后较差,可能与其间质淋巴细胞浸润程度以及小管间质损伤较重有关。
In this paper, the distribution of CD_4 ~ +, CD_8 ~ + and B cells in renal biopsies of 20 patients with primary IgA nephropathy was observed by monoclonal antibody and PAP four-layer method. Among them, 10 cases showed massive proteinuria (NP group) and another 10 cases were recurrent gross hematuria (GH group). The results showed that in patients with IgA nephropathy CD_4 ~ +, CD_8 ~ + and B cells are mainly distributed in the stroma, few glomerular lymphocytes. The levels of CD_4, CD_8 ~ + and B cells in the NP and GH groups were significantly higher than those in the normal control group, of which the NP group increased more obviously. There was no significant difference between the three groups of RT values. There was no significant difference in glomerular lesions between the two groups, but the interstitial tubulointerstitial lesions in NP group were significantly higher than those in GH group. In the NP group, more CD_4 ~ + cells aggregated in the stroma. This study showed poor prognosis in patients with NP group may be interstitial infiltration of interstitial cells and tubulointerstitial injury related.