微创经皮肾镜碎石取石术小剂量地塞米松干预对肾结石疗效影响价值研究  

Effect of low-dose dexamethasone intervention in minimally invasive percutaneous nephrolithotomy on the efficacy of kidney stones

作　　者：凌峰 薛珺[2] 章钟 徐启鹏 LING Feng;XUE Jun;ZHANG Zhong;XU Qipeng(Ningguo People’s Hospital,Ningguo 242300,China)

机构地区：[1]宁国市人民医院,安徽宁国242300 [2]南京医科大学第二附属医院,江苏南京210003

出　　处：《陕西医学杂志》2024年第8期1077-1080,共4页Shaanxi Medical Journal

基　　金：江苏省自然科学基金资助项目(2020JQ-363)。

摘　　要：目的:探讨微创经皮肾镜碎石取石术(MPCNL)术中小剂量地塞米松干预对肾结石疗效影响价值。方法:选取170例肾结石患者,根据随机数字表法将患者分为观察组(MPCNL术+小剂量地塞米松)和对照组(MPCNL术),各85例。比较两组手术相关指标、治疗前后血清谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)、超氧化物歧化酶(SOD)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-18、C-反应蛋白(CRP)及血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)、β_(2)-微球蛋白(β_(2)-MG)水平。观察术后3个月内并发症发生情况。结果:观察组住院时间、术后抗生素使用时间以及拔除肾造瘘管时间较对照组缩短(均P<0.05)。治疗后血清GSH-Px、MDA、SOD、TNF-α、IL-6、IL-18、CRP较治疗前降低,且观察组低于对照组(均P<0.05)。治疗后血清NGAL、KIM-1、β_(2)-MG水平高于治疗前,且观察组低于对照组(均P<0.05)。对照组并发症发生率14.12%高于观察组4.71%(P<0.05)。结论:肾结石患者MPCNL术中应用小剂量地塞米松干预有助于减轻机体氧化应激和炎症反应,降低血清NGAL、KIM-1、β_(2)-MG水平,且安全性较高。Objective:To investigate the effect of low-dose dexamethasone intervention in minimally invasive percutaneous nephrolithotomy(MPCNL)on the efficacy of kidney stones.Methods:A total of 170 patients with kidney stones were selected and divided into the observation group(MPCNL+low-dose dexamethasone)and the control group(MPCNL)according to the random number table method,85 cases in each group.The operation related indicators,serum glutathione peroxidase(GSH-Px),malondialdehyde(MDA),superoxide dismutase(SOD),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-18,C-reactive protein(CRP)and serum neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1),β_(2)-microglobulin(β_(2)-MG)level before and after treatment were compared between the two groups.The occurrence of complications within 3 months after operation was observed.Results:The hospitalization time,postoperative antibiotic use time and nephrostomy tube extraction time in observation group were shorter than those in control group(all P<0.05).After treatment,serum GSH-Px,MDA,SOD,TNF-α,IL-6,IL-18 and CRP were lower than those before treatment,and the observation group was lower than the control group(all P<0.05).Serum levels of NGAL,KIM-1 and β_(2)-MG after treatment were higher than before treatment,and lower in observation group than control group(all P<0.05).The complication rate of control group was 14.12%higher than that of observation group 4.71%(P<0.05).Conclusion:The application of low-dose dexamethasone intervention in MPCNL in patients with kidney stones can alleviate oxidative stress and inflammatory response,and reduce serum levels of NGAL,KIM-1 and β_(2)-MG,with high safety.

关 键 词：肾结石 微创经皮肾镜碎石取石术 小剂量地塞米松 氧化应激 中性粒细胞明胶酶相关脂质运载蛋白 肾损伤分子-1 β_(2)-微球蛋白 

分 类 号：R692.4[医药卫生—泌尿科学]