14 ~ 36周自然流产胎儿肾组织发生的测定

Divya Jain Pokarna, K. Kshitija, S. Saritha
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摘要

目的和目的:肾脏的发育是一个复杂的过程,包括收集和排泄两个部分。由于医学领域的最新进展,现在早产儿成功存活是可能的。人类胎儿肾脏形态和发育解剖的原始概念对正常和先天性疾病如肾母细胞瘤、肾积水、多囊性发育不良肾、常染色体隐性多囊肾病、巨囊性肾炎、肾发育不良等的产前诊断具有重要意义。《根据胎龄的肾脏组织发生》概述了这些先天性异常,这些异常对于发育解剖学家、遗传学诊断、放射学和组织病理学诊断以及最终即兴产前筛查和预测治疗路线非常重要。方法:选取20例自然流产胎儿(男11例,女9例)的40个肾脏,妊娠期14 ~ 36周。在用CRL确认年龄后,将它们分组,然后处理成苏木精和伊红染色的载玻片。光镜下观察染色的载玻片。结果:在孕早期,所有肾脏分叶并在36周融合。18周时,皮质-髓交界处和预先形成的集合小管清晰可见。19 ~ 23周形成分化良好的PCT和DCT。28周形成良好的金字塔和29周的髓质射线明显区分。Henle环在28周形成并分化。在32 ~ 36周时,血管功能增加。肾原带和未分化间质减少,成熟肾小球增加。结论:本研究有助于我们对各种肾脏疾病的认识。本研究还可以重点观察肾髓质和皮质各组成部分的发育情况,以及不同胎龄肾脏的组织成熟度和功能状态,使我们对肾脏的发育有一个全面的了解。
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Determination of Histogenesis of Human Kidney in Spontaneously Aborted Human Fetuses from 14 Weeks to 36 Weeks
Aims and Objectives: The development of Kidney is a complex process having two parts the collecting & excretory part. Due to recent advances in the medical field it is now possible for premature babies to survive successfully. The original conception of   human fetal Kidney morphology and developmental anatomy is very important for prenatal diagnosis of normal and congenital disorders such as Wilm’s tumor, Hydronephrosis, Multicystic dysplastic kidney, Autosomal recessive polycystic kidney disease, Megacystis, Renal dysplasia etc.  Histogenesis of Kidney according to its gestational age gives overview  of  these congenital anomalies that are important for a developmental Anatomist , in diagnosing the Genetics aspects, Radiological   and Histopathological diagnosis & finally  improvising antenatal screening and forecasting the route of treatment. Methods: The study used 40 kidneys obtained from 20 spontaneously aborted foetuses [11 males and 9 females] ranging in gestation from 14 weeks to 36 weeks. After confirming their age with CRL, they were grouped and then processed to form slides stained with hematoxylin and eosin. The stained slides were seen under light microscope. Results: At an early gestational age, all kidneys were lobulated and fused by 36 weeks. By 18 weeks, the corticomedullary junction and preformed collecting tubules were plainly visible. By 19 to 23 weeks, well-differentiated PCT and DCT had formed. Well formed pyramids by 28 weeks and medullary rays by 29 weeks were clearly distinguished. Loop of Henle developed and distinguished by 28 weeks. Increased vascularity was seen by 32 weeks to 36 weeks. Nephrogenic zone and undifferentiated mesenchyme decreased and matured glomeruli increased by 36 weeks. Conclusion: This present study may help us in understanding various renal disorders. This study can also emphasizes on the development of each component in medulla and cortex of Kidney, regarding histological maturity & functional status according to gestational age & gives us an overall panoramic view.
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