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庆大霉素的肾毒性与溶酶体病变

NEPHROTOXICITY OF GENTAMICIN AND LYSOSOMAL ALTERATIONS

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【作者】 邹万忠王盛兰衡万杰刘平许淑英汤秀英

【Author】 Department of Pathology Zou Wan-zhong,et al

【机构】 北京医科大学病理教研室北京医科大学肾病研究中心北京医科大学第一医院病理科

【摘要】 用雄性杂种灰兔每天一次肌肉注射硫酸庆大霉素150mg/kg,每天杀检3只共7天。电镜下可见近端肾小管上皮细胞的细胞器肿胀、变性,溶酶体增多伴有髓样小体形成,乃至细胞崩解坏死,肾小球上皮细胞和内皮细胞也有类似病变。主要由于庆大霉素沉积于溶酶体内,使磷脂酶受到抑制造成,为继发性溶酶体贮积病。

【Abstract】 23 male mongrel grey rabbits received gcntamicin sulfate 150 mg/kg daiiy by intramuscular injection for 7 consecutive days. 3 animals were killed every day. The proximal tubular celis of kidney showed cloudy swelling, granular and lipoid dcgcneration during 1-4 days by light microscopy, but from 5 to 7 days focus and diffuse proximal tubular necrosis appcared. Electron microscopy: Organelle of proximal tubular celis showed alteration, primary and secondary lysosomes increased, many myiloid bodies were present, and some celis showed necrosis. Thcse lesions were found severe on the 4 th day and became more severe day by day. These lesions could also be seen in the epithelial and endothelial celis of glomerulus with foot process fusion. The formation of these lesions is due to accumulation of gentamicin in lysosome, and as a result, phospholipase and sphingomyelinase are inhibited, and phospholipidosis is induccd. Acquircd lysosomal storage disorders are thus formed.

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