摘要
目的建立多次重复ESWL治疗兔肾功能累积性损害模型,探讨ESWL对肾功能的累积损伤,指导ESWL的临床应用。方法雄性成年兔72只,随机分为6组。分别于ESWL前及完成ESWL治疗后留取尿液,检测ESWL前后尿液中GGT、NAG、Cr的变化;以彩色多普勒血流显像(CDFI)测定兔ESWL前后双侧肾脏血流指数(RI)的变化;切片观察、计数镜下100倍视野平均肾小球数、免疫组化染色检测TGF-β及Ⅳ型胶原表达情况。结果①不同ESWL治疗组及对照组间尿液Cr、r-GT、NAG均数间差异有统计学意义(P<0.0001),对照组与6次ESWL组、8次ESWL组、10次ESWL组之间两两比较差异有统计学意义(P<0.0001)。②不同ESWL治疗组及对照组间100倍视野平均肾小球数间差异有统计学意义(P<0.0001),对照组与6次ESWL组、8次ESWL组、10次ESWL组之间两两比较差异有统计学意义(P<0.0001)。结论重复、多次ESWL对肾脏损害具有累积性,呈纤维化改变,应该引起泌尿工作者应用ESWL治疗肾结石的重视。
Objective To establish a repeat cumulative renal damage model in rabbits with repeat extracorporeal shock wave lithotripsy（ESWL）,access the cumulative damage of ESWL on kidney,and provide a guidance for the clinical application ESWL.Methods Seventy two male rabbits were randomly divided into 6 groups and underwent ESWL;The urine samples were collected before and after ESWL to detect the levels of GGT,NAG and Cr;The RI of rabbit kidneys before and after ESWL were detected by color Doppler flow imaging（CDFI）;The changes of tissue structure（numbers of glomerulus） were observed by H.E.staining;the expressions of TGF-β1 and collagen IV were dtected by immunohistochemical staining.Results ①There were significant difference in the value of urine Cr,r-GT and NAG in different ESWL trial groups and control group;and also between the control group and ESWL group and among each ESWL group（6 times,8 times and 10 times of ESWL）,P0.0001;②There were significant difference in the average numbers of glomerulus between ESWL group and control group;and also between each ESWL groups（P0.0001）.Conclusion The repeat and multiple ESWL can cause a cumulative renal damage and fibrolification.The application of ESWL on renal stone patients should be strictly performed according to the indications and the status of renal function.
出处
《中华全科医学》
2011年第12期1828-1830,共3页
Chinese Journal of General Practice
基金
安徽省卫生厅课题(2008B011)
