压力灌注对不同程度积水肾损伤的评价  

Evaluation of Renal Injury in Different Levels of Hydronephrosis Under Pressure Perfusion

作　　者：余伟民[1] 曹智修[1] 姚小兵[1] 饶婷[1] 袁润[1] 李维[1] 程帆[1] 张孝斌[1] 

机构地区：[1]武汉大学人民医院泌尿外科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2014年第6期839-842,共4页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:81200501)

摘　　要：目的:探讨急性肾盂内压升高对不同程度积水肾损伤的情况。方法:采用腰大肌包埋法分别建立新西兰大白兔轻度和重度肾积水模型,轻度积水组分为M0、M1、M2和M3组,重度积水组分为S0、S1、S2和S3组,每组6只。对应分别以0,20,60,100mmHg压力进行灌注,48h后取标本分别检测组织中富含半胱氨酸蛋白61(Cyr61)和肾损伤因子-1(Kim-1)的表达情况,并观察组织细胞的微观形态变化。结果:随灌注压力升高,轻度和重度积水肾组织均表现为肾小管细胞坏死的比例升高。轻度积水组经100mmHg灌注后(M3),组织中Cyr 61和Kim-1的表达评分分别为4.50±0.37和4.39±0.35,和对照组(M0)相比均有显著升高(P<0.05),但M1和M2组变化不明显(P>0.05);与对照组(S0)相比,重度积水组经60和100mmHg灌注后(S2和S3),Cyr 61表达评分分别为4.20±0.42和4.58±0.53,Kim-1表达评分分别为4.38±0.32和4.45±0.37,均有显著升高(P<0.05),但S1与S0比较无显著改变(P>0.05)。结论:肾盂灌注压力的升高会导致积水肾缺血损伤,不同程度积水肾耐受灌注压力的大小存在差异。Objective：To investigate the injury of acute increased renal pelvis pressure in varying degrees of hydronephrosis.Methods：The mild and severe hydronephrosis model in New Zealand white rabbits were established by psoas embedding.Mild hydronephrosis group was divided into M0,M1,M2 and M3groups,while severe hydronephrosis group was divided into S0,S1,S2 and S3groups（n=6）,corresponding to 0,20,60 and 100mmHg renal pelvis perfusion pressure,respectively.Specimens were detected after 48 h,including the expression of cysteine-rich protein 61（Cyr 61）and renal injury factor-1（Kim-1）,and the microscopic observation of morphological changes of tissues.Results：With the increased perfusion pressure,mild and severe hydronephrosis groups showed renal tubular necrosis proportion increased.The group of 100 mmHg perfusion（M3）in mild hydronephrosis,tissue expression scores of Cyr 61 and Kim-1were4.50±0.37 and 4.39±0.35,which were significantly elevated when compared with that respectively in control group（M0）（P〈0.05）,but no significant changes were found in M1 and M2groups（P〉0.05）.Compared with the control group（S0）,the expression scores of Cyr 61 in S2and S3 groups were 4.20±0.42 and 4.58±0.53,respectively,Kim-1scores were 4.38±0.32 and 4.45±0.37,respectively,and both were significantly elevated（P〈0.05）,but no significant change were found in the S1 group.Conclusion：Pelvis perfusion pressure rise will cause ischemic injury in hydronephrosis,and the tolerance was different in varying degrees of hydronephrosis when the renal pelvis perfusion pressure increased.

关 键 词：肾积水 肾损伤 富含半胱氨酸蛋白61 肾损伤因子-1 

分 类 号：R692.2[医药卫生—泌尿科学]