银杏叶提取物保护体外冲击波碎石术致早期肾损伤的作用及机制  

The effect and mechanism of extract of Folium Ginkgo in protecting the early renal injury caused by extracorporeal shock wave lithotripsy

作　　者：赵俊龙[1] 姜宁[2] 李岩[1] 徐冀东[2] 张鹤[2] 胡传义[2] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]上海市浦东新区公利医院泌尿外科,上海200135

出　　处：《中国医药导报》2017年第21期82-85,共4页China Medical Herald

基　　金：上海市卫生和计划生育委员会重点专科建设计划项目(ZK2015A11);上海市浦东新区卫生和计划生育委员会科研基金面上项目(PW2014A-30)

摘　　要：目的研究银杏叶提取物在肾结石体外冲击波碎石术(ESWL)致早期肾损伤中的保护作用,并探讨其可能的机制。方法将上海市浦东新区公利医院2016年1月~2017年1月收治的80例行ESWL的单侧肾盂/肾盏结石患者随机分成观察组和对照组,每组40例。观察组于ESWL前3 d将银杏叶提取物20 mL加入生理盐水250 mL中静滴,q12h,5 d;对照组为同时间节点给予生理盐水250 mL静滴。比较两组患者碎石前后肾损伤情况[尿中性粒细胞明胶酶相关载脂蛋白(NGAL)、尿半胱氨酸蛋白酶抑制剂C(Cys-C)]和血清氧自由基水平[丙二醛(MDA)、髓过氧化物酶(MPO)]、抗氧化水平[总抗氧化能力(TAC)、总超氧化物歧化酶(TSOD)]的差异。结果 ESWL术后24 h,观察组尿NGAL和尿Cys-C的水平[(17.56±3.94)、(38.29±3.84)ng/mL]低于对照组[(22.68±4.82)、(45.63±5.37)ng/mL],差异有高度统计学意义(P<0.01);血清MDA和MPO水平[(5.05±0.84)mmol/L、(68.64±21.35)U/mg]低于对照组[(5.91±1.13)mmol/L、(76.28±22.17)U/mg],差异有统计学意义(P<0.05);血清TSOD和TAC水平[(147.65±43.38)k U/L、(12.58±3.34)U/mg]高于对照组[(123.52±41.29)k U/L、(8.35±2.14)U/mg],差异亦有统计学意义(P<0.05、P<0.01)。结论银杏叶提取物能有效保护ESWL所致的早期肾损伤,其机制可能是通过增强机体抗氧化能力、清除氧自由基而起作用。Objective To study the protective effect of extract of Folium Ginkgo in the early renal injury caused by extracorporeal shock wave lithotripsy（ESWL）, and to explore it possible mechanism. Methods Eighty patients with unilateral lithotripsy pelvis/calyceal calculi underwent ESWL admitted to Shanghai Pudong New Area Gongli Hospital from January 2016 to January 2017 were randomly divided into observation group and control group, with 40 cases in each group. The observation group was administrated with Folium Ginkgo 20 mL plus normal saline 250 mL, 3 d before ESWL, intravenous drip, q12 h, 5 d; the control group was administrated with normal saline 250 mL at the same time point. The differences of renal injury [urine neutrophil gelatinase-associated lipocalin（NGAL）, cystatin C（Cys-C）] and the levels of serum oxygen radical [malondialdehyde（MDA）, myeloperoxidase（MPO）], antioxidation [total antioxidant capacity（TAC）, total superoxide dismutase（TSOD）] before and after lithotripsy in the two groups were compared. Results24 h after ESWL, the levels of urine NGAL and urine Cys-C in observation group [（17.56 ±3.94）,（38.29±3.84） ng/mL]were lower than those of control group [（22.68±4.82）,（45.63±5.37） ng/mL], the differences were highly statistically significant（P〈0.01）; the levels of serum MDA and MPO [（5.05±0.84） mmol/L,（68.64±21.35） U/mg] were lower than those of control group [（5.91±1.13） mmol/L,（76.28±22.17） U/mg], the differences were statistically significant（P〈0.05）; the levels of serum TSOD and TAC [（147.65 ±43.38） kU/L,（12.58 ±3.34） U/mg] were higher than those of control group[（123.52±41.29） kU/L,（8.35±2.14） U/mg], the differences were also statistically significant（P〈0.05, P〈0.01）. Conclusion The extract of Folium Ginkgo can effectively protect the renal injury caused by ESWL, the mechanism may be through enhancing the antioxidation ability and eliminating oxygen free radicals.

关 键 词：银杏叶提取物 体外冲击波碎石术 肾损伤 氧自由基 

分 类 号：R692[医药卫生—泌尿科学]