摘要：目的 研究肾组织各种浸润细胞在新月体肾炎的发病机制中的作用。方法 分析56例各类新月体肾炎患者肾组织中CD68⁺及PCNA⁺细胞在各类新月体肾炎患者肾组织中的分布特点，并就它们与肾组织中CD4 及CD8⁺细胞浸润的关系进行分析探讨。结果 本组新月体肾炎患者肾组织中 CD68⁺、PCNA⁺、CD4⁺及CD8⁺细胞均明显高于正常供肾组织。在Ⅰ型新月体肾炎患者肾组织中CD68+及PCNA+细胞数高于Ⅱ型及Ⅲ型新月体肾炎患者。肾间质CD4⁺与肾小球cD68⁺及PCNA⁺细胞数呈线性相关者主要表现在Ⅲ型及Ⅰ型新月体肾炎患者。结论 肾间质CD4⁺与单核细胞及PCNA⁺细胞呈直线正相关可能为新月体肾炎患者活动与否的一种标志。在狼疮性新月体肾炎患者肾组织中CD4⁺及CD68⁺细胞浸润与血管炎及Ⅲ型新月体肾炎患者相似，提示这些患者在新月体的形成中主要由细胞免疫异常所参与。

The distribution and significance of renal infiltrating cells in patients with diffuse crescentic glomerulonephritis

TANG Zheng ,WU Yan ,HU Weixin

(Department of Nephrology,Jinling Hospital, School of Medicine, Nanjing University,Nanjing 210002,China)

Abstract：Objective To investigate the significance and distribution of renal infiltrating cells including monocytes (CD68⁺ cell),proliferative nuclear antigen positive cells (PCNA⁺ cell),CD4⁺ and CD8⁺ cells in diffuse crescentic glomerulonephritis (DCGN). Methods 56 patients with DCGN were studied,including 10 case of anti-glomerular basement membrane (GBM) -type I DCGN,26 complex immune-type Ⅱ DCGN,and 20 case of pauci-immune-type Ⅲ DCGN.The glomerular and interstitial infiltrates of CD68⁺ and PCNA⁺ cells, and the interstitial infiltrates of CD4⁺ and CD8⁺ cells were detected by four-layer PAP method.Results There was a significant increase of renal infiltrating CD68⁺,PCNA⁺,CD4⁺ and CD8⁺ cells in patients with DCGN compared with that in donors.In patients with type I DCGN,there was a higher of renal infiltrating CD68⁺ and PCNA⁺ cells than that in patients with type Ⅱ and Ⅲ DCGN.The glomerular infiltrates of CD68⁺ and PCNA⁺ cells correlated with the interstitial infiltrates of CD4⁺ cells in type Ⅰ or Ⅲ DCGN patients.In lupus DCGN,the numbers of renal infiltrating CD68⁺ cells PCNA⁺ cells were similar to vasculitis or type Ⅲ DCGN patients.Conclusions These findings demonstrate that (1) the renal infiltrates of CD68⁺ and PCNA⁺ cells play an important role in patients with DCGN.(2)the renal infiltrates of CD4⁺ cells correlated with the infiltrates of CD68⁺ and PCNA⁺ cells may be an active marker of DCGN.(3) the cell-mediated immune pathogenesis may contribute to crescentic formation in lupus DCGN patients.

Keywords：Glomerulonephritis;Immune;Pathology;Infiltrating cell参考文献：

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收稿日期：1999-07-23