美乐托宁对慢性不完全性肾盂输尿管连接处梗阻兔输尿管组织诱导型一氧化氮合酶的影响

发布时间：2018-04-22 19:27

  本文选题：美乐托宁 + UPJO　； 参考：《福建医科大学》2014年硕士论文

【摘要】：【目的】探讨美乐托宁对慢性不完全性肾盂输尿管连接处梗阻（UPJO）兔输尿管组织诱导型一氧化氮合酶（iNOS）的影响和意义。 【方法】成年新西兰兔32只，雌雄不限，随机分成4组，每组8只，正常组A，假手术组B，手术组C，手术+药物组D；A组不做任何处理，B、C、D组均行开腹手术暴露左侧肾盂输尿管连接处，B组不做任何处理后关腹，C、D组手术制作UPJO模型。造模成功后，所有兔子均给予清水和普通饲料喂养，D组于术前1周及术后加用美乐托宁喂养至实验结束。术前、术后第1、2、4、8周行静脉肾盂造影（IVP）了解尿路梗阻情况，同时于术后1、2、4、8周开腹行术侧梗阻处尿一氧化氮（NO）浓度检测，随后取梗阻处输尿管组织行HE染色观察其结构病理变化并采用免疫组化检测iNOS的表达情况。 【结果】1、IVP：C组术后第1周出现肾积水，D组术后第4周出现肾积水，严重程度均随术后时间推移而加重；C组显影时间明显长于A、B、D组(P0.05)，且随术后时间推移而增加；术后第4周开始，D组显影时间明显长于A、B组(P0.05)，且随术后时间推移而增加。2、梗阻处尿NO浓度：C、D组尿NO浓度均明显高于A、B组(P0.05)，且随术后时间推移而增高；D组尿NO浓度明显低于C组(P0.05)。3、梗阻处输尿管组织HE染色：A、B组输尿管各层结构基本正常；C组黏膜层呈炎症增生改变，平滑肌层结构紊乱，大量纤维组织增生；D组病变介于A、B组和C组之间。4、梗阻处输尿管组织免疫组化：iNOS主要表达于输尿管平滑肌层，各组表达程度依次为：CDBA (P0.05)；C组表达程度随术后时间推移而增强；D组表达程度于术后第4周开始随术后时间推移而增强。 【结论】1、UPJO梗阻处iNOS表达及尿NO浓度明显增加，且均随梗阻程度加重而增加，尿NO可能可以作为判断梗阻程度指标，有潜在临床应用价值。2、iNOS与尿NO参与UPJO致肾积水的病理过程，，与肾功能损害密切相关。3、美乐托宁可能通过抑制iNOS的过度表达从而减少NO的产生，降低尿NO浓度，减缓氧化损伤作用，减轻梗阻处输尿管组织的病理改变，从而改善肾积水，保护肾功能。
[Abstract]:[objective] to investigate the effect and significance of melatonin on ureteral tissue inducible nitric oxide synthase (iNOS) in rabbits with chronic incomplete ureteropelvic junction obstruction (UPJO). [methods] Thirty-two adult New Zealand rabbits, male and female, were randomly divided into 4 groups with 8 rabbits in each group. Normal group A, sham operation group B, operation group C, operation drug group D group without any treatment, group D all underwent open operation to expose left pelvis and ureteral junction, group B did not do any treatment, then closed abdomen to make UPJO model. All rabbits were fed with clear water and common feed for 1 week before operation and after operation with melatonin until the end of the experiment. Before operation, intravenous pyelography (IVP) was performed 8 weeks after operation, and urinary nitric oxide (no) concentration was detected at 1, 2, 4 and 8 weeks after operation. The ureteral tissues were stained with HE and the expression of iNOS was detected by immunohistochemistry. [results] 1in group C, hydronephrosis occurred at the first week after operation. The severity of hydronephrosis in group D was significantly longer than that in group A (P 0.05) and increased with time after operation. From the 4th week after operation, the development time of group D was significantly longer than that of group A B (P 0.05), and increased with the passage of time. The concentration of no in group D was significantly higher than that in group A B (P 0.05), and the concentration of no in group D was significantly higher than that in group A (P 0.05). It was significantly lower than that in group C (P 0.05). The ureteral tissue in the obstruction was stained with HE in the ureteral tissue. The ureteral layers in group B were basically normal and the mucosal layer in group C showed inflammatory hyperplasia. The structure of smooth muscle layer was disordered, the pathological changes of group D were between group A B and group C, and the pathological changes of group D were between group A B and group C. the immunohistochemical staining of the ureteral tissue was mainly expressed in the smooth muscle layer of ureter. The degree of expression in group C was increased with the passage of time after operation. The expression level of group D increased with the passage of time from the 4th week after operation. [conclusion] 1 the expression of iNOS and the concentration of no in urine increased significantly in the obstructive site of UPJO, and both of them increased with the severity of obstruction. Urinary no may be used as an index to judge the degree of obstruction, and it has the potential clinical application value of .2iNOS and no in the pathological process of hydronephrosis induced by UPJO. Melatonin may reduce the production of no, decrease the concentration of no in urine, reduce the effect of oxidative injury, alleviate the pathological changes of ureteral tissue in obstruction, and improve hydronephrosis by inhibiting the overexpression of iNOS. Protect renal function.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R693.2


本文编号：1788585