慢性肾衰竭对听力的影响及其机理研究  

Study on The Effects of Chronic Renal Failure on Hearing and Its Mechanism

作　　者：王永华[1] 刘旺[1] 刘金洪[1] 

机构地区：[1]浙江中医药大学听力及语言科学系,杭州310053

出　　处：《浙江中医药大学学报》2006年第2期183-188,共6页Journal of Zhejiang Chinese Medical University

基　　金：国家自然科学基金资助计划项目(No:30472230)~~

摘　　要：[目的]观察慢性肾衰对听力的影响并探讨其机理。[方法]将Wistar雄性大鼠29只,随机分为12天空白对照组6只,12天实验组8只,24天空白对照组6只,24天实验组9只。实验组分别进行12天和24天腺嘌呤(300mg/Kg)灌胃,造成慢性肾衰模型。以脑干听觉诱发电位(BAEP)评价各组动物听功能的变化;分别测定各组大鼠肾功能(血清Cr、BuN);光镜下肾组织形态学观察,并测定肾胶原含量;免疫组化观察NOSⅡ在耳蜗的表达情况。[结果]随着肾功能的损害,血清Cr、BuN、明显升高(P<0·001);BAEP阈值和潜伏期分别逐渐增高和延长;光镜下肾组织纤维化程度逐渐增高;耳蜗组织免疫组化显示,空白对照组NOSⅡ在耳蜗血管纹、内外毛细胞、螺旋神经节细胞均有不同程度的弱阳性表达,伴随肾功能的损害,上述各部位的表达逐渐增强,其中以血管纹的表达最强,依次是螺旋神经节细胞,内、外毛细胞。[结论]慢性肾衰可引起耳聋,其原因可能与代谢产物毒性作用有关。肾衰后耳蜗NOS活性增高,大量生成NO,对血管纹、螺旋神经节细胞、内外毛细胞产生毒性损害,可能是慢性肾衰引起耳聋的重要机制之一。[Objective] To observe the effects of chronic renal failure （CRF）on hearing and investigate its mechanism.[ Methods] Twenty-nine male wistar rats were randomly divided into four groups： I the normal rats as control for 12 days （n： 6） ; Ⅱ rats given adenine（ig） for 12 days （n：8） ; Ⅲ the normal rats as control for 24 days （n：6） ; Ⅳ rats given adenine（ig） for 24 days（n：9）. The rat model of CRF was produced by being perfused of adenine [300mg/kg]for 12d and 24d. Brain-stem auditory evoked potential （BAEP） was utilized to evaluate the auditory function and renal tissue morphology was observed; Serum sampling was used to determine the content of Cr, BuN. The expression of NOS Ⅱ in the cochlear was measured by immunohistochernical technique.[Results] After adenine given for 12d or 24d, the Cr and BuN were in significant higher level than that in control group. The BAEP thresholds were gradually higher than that in control group, the BAEP delitescence prolonged. Light microscopic observation of renal tissue showed that the degree of fibrosis was gradually higher. Data of immune histochemistry about the cochlear tissue showed that the expressions of NOS Ⅱ were feebly positive in the cochlear vassal texture, inner-outer hairy cell and helical-ganglion cell, and following functional damage of the kidney, their expressions reinforced gradually, amongst which strongest expression was vassal texture, the next helical-ganglion cell, the last inner-outer hairy cell. [Conclusion]CRF can result in deafness. It is likely concerned with toxic effects of the metabolizable substance, the metabolizable dysfunction of the electrolyte, shortage of trace elements, etc. One of the important mechanisms of the effects of CRF on hearing is the toxic damage of NO to cochlea.

关 键 词：肾功能衰竭 耳蜗 脑干 一氧化氮 肾 

分 类 号：R692.5[医药卫生—泌尿科学]