低能量冲击波预处理对体外冲击波肾损伤的保护作用  

Prevention of extracorporeal shock wave lithotripsy-induced renal Injury by pre - treating kidneys with low-energy shock waves

作　　者：桂西青[1] 郭振宇[1] 孙华宾[1] 郑巍[1] 殷放[2] 

机构地区：[1]中山大学附属第五医院泌尿外科,广东珠海519000 [2]中山大学附属第五医院普外科

出　　处：《中国医师杂志》2008年第6期770-772,共3页Journal of Chinese Physician

摘　　要：目的探讨低能量冲击波（LESW）预处理对体外冲击波（ESW）肾损伤的保护作用及机制。方法制成单肾的40只雌性家兔随机等分为对照组、LESW组、ESW组、ESW＋LESW预处理组。LESW组肾接受100次LESW；ESW组肾接收标准的1500次ESWL；ESW＋LESW预处理组预先按LESW组处理，3min后同ESW组处理。24h时观察肾组织超氧化物歧化酶（SOD）活性、丙二醛（MDA）含量和尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）变化，原位缺口末端标记法（TUNEL）检测肾凋亡细胞。结果与ESW组比较，LESW预处理组肾组织SOD活性增高（P〈0．05），MDA含量和细胞凋亡指数降低（P〈0．01）、尿NAG降低（P〈0．01）。与对照组比较。LESW组各项指标差异无统计学意义（P〉0．05）。结论LESW预处理可减轻ESW肾损害，与其抗氧化应激损伤、抗细胞凋亡有关。Objective To investigate the prevention and mechanism of Extracorporeal shock wave lithotripsy （ESW） induced renal Injury by pre - treating kidneys with low-energy shock waves （LESW）. Methods Forty healthy female domestic rabbits were surgically managed to the mono-nephron models and random divided into 4 groups consisting of ten each： Control, LESW, ESW and ESWL plus LESW pretreated groups. LESW group received 100 LESW, ESW group received 1500 standard ESW, and same dose on ESW group except 100 LESW pretreatment in ESW plus LESW pretreated group. The rabbit kidney tissues were obtained 24 hours after ESW. Activity of superoxide dismutase （SOD） and malondialdehyde （MDA） levels in the renal tissue, and the level of N-acetyl-β-D-glucosaminidase （NAG） in urinary were measured. Renal cell apoptosis was detected by TdT-mediated dUTP Nick End Labelling （TUNEL）. Results The MDA, the urinary level of NAG and rate of apoptosis in the LESW groups were reduced （ P 〈0. 01 ）, and the activity of SOD increased significantly （ P 〈 0. 05） as compared with ESW group, and these changes in LESW group had no statistics difference compared with the control group（ P 〉 0. 05 ）. Conclusions LESW pretreatment protocol substantially limits the renal injury that often caused by ESW. LESW may suppress oxidative stress and antagonize the process of renal cellular apoptosis.

关 键 词：高能量冲击波/治疗应用 碎石术 肾/损伤/病理生理学 

分 类 号：R691.4[医药卫生—泌尿科学]