急性压力灌注对不同程度肾积水模型兔肾脏的损伤

发布时间：2018-05-05 17:23

  本文选题：动物模型 + 肾积水　； 参考：《武汉大学学报(医学版)》2015年01期

【摘要】：目的:探讨输尿管套扎法建立兔肾积水模型的可行性及急性压力灌注对不同程度积水肾肾脏损伤的影响,为临床经皮肾镜和输尿管镜过程中灌注压力的选择提供依据。方法:健康新西兰大白兔45只,随机分为正常组(N组,n=5)、轻度积水组(M组,n=20)和重度积水组(S组,n=20)3组。轻度积水及重度积水组模型采用套管法构建。轻度积水组与重度积水组分别于结扎后3,7d行彩色多普勒超声检查以判别积水程度。M组和S组随机分为M0-M3和S0-S3 4个压力灌注亚组,M0-M3和S0-S3分别行0,20,60,100mmHg压力灌注,N组行100mmHg压力灌注。术后48h取肾脏标本,免疫组化检测标本中TNF-α及IL-8的表达。结果:输尿管套扎法模型构建成功率达90%,与正常肾脏相比,结扎后3d行彩色多普勒超声检查,M组可见集合系统分离,有少量液性暗区;结扎后7d检查,S组可见集合系统分离明显,肾皮质变薄,液性暗区占据肾脏大部分区域。M组行0,20,60mmHg灌注时IL-8、TNF-α表达量均无明显变化(P0.05),行100mmHg灌注时IL-8及TNF-α表达量明显增加(P0.05);S组行0,20mmHg灌注时IL-8、TNF-α表达量均无明显变化(P0.05),行60,100mmHg灌注时IL-8、TNF-α表达量明显增加(P0.05);N组行100mmHg灌注时IL-8、TNF-α表达量与M0、S0相比无明显差别(P0.05)。结论:输尿管套扎法建立兔肾积水模型具有可行性,不同程度积水肾对急性压力灌注的耐受能力不同,高灌注压力更容易对积水程度重的肾脏造成损伤,在经皮肾镜和输尿管镜治疗结石过程中应尽量减少过高压力灌注以保护积水肾脏。
[Abstract]:Objective: to investigate the feasibility of ureteral ligation in the establishment of rabbit hydronephrosis model and the effect of acute pressure perfusion on renal injury of hydronephrosis of different degrees, and to provide evidence for the selection of perfusion pressure during percutaneous nephroscopy and ureteroscopy. Methods: Forty-five healthy New Zealand white rabbits were randomly divided into three groups: normal group (n = 5), mild hydronephrosis group (n = 20) and severe hydronephrosis group (n = 20). The models of mild and severe hydronephrosis were constructed by casing method. The mild hydronephrosis group and the severe hydronephrosis group were examined by color Doppler ultrasound on the 7th day after ligation to distinguish the degree of hydronephrosis. Group S and group M were randomly divided into four pressure perfusion subgroups: M0-M3 and S0-S3. M0-M3 and S0-S3 were treated with 100mmHg pressure perfusion respectively. The expression of TNF- 伪 and IL-8 was detected by immunohistochemistry. Results: the success rate of ureteral ligation was 90%. Compared with normal kidney, 3 days after ligation, the collecting system was separated and there were a few liquid dark areas in group M. On the 7th day after ligation, the collecting system was separated obviously and the renal cortex became thinner in S group. There was no significant change in the expression of IL-8 TNF- 伪 during perfusion with 0 ~ 20 ~ (60) mmHg in the liquid dark area. The expression of IL-8 and TNF- 伪 in the 100mmHg group was significantly increased, while the expression of IL-8 TNF- 伪 in the 0 ~ (20) mm Hg perfusion group had no significant change. The expression of IL-8 TNF- 伪 in the 60100mmHg perfusion group was not significantly different from that in the 0 ~ (20) mm Hg group, while the expression of IL-8 TNF- 伪 in the 60100mmHg perfusion group was significantly higher than that in the control group (0 ~ 20 mm Hg). The expression of IL-8 TNF- 伪 in 100mmHg group was significantly increased compared with that in M0 / S0 group. There was no significant difference in the expression of IL-8 and TNF- 伪 between P0. 05 and M0 / S0 group (P 0. 05). Conclusion: it is feasible to establish a rabbit model of hydronephrosis by ureteral ligation. Different degrees of hydronephrosis have different tolerance to acute pressure perfusion, and high perfusion pressure is more likely to cause damage to the kidney with severe hydronephrosis. During percutaneous nephroscopy and ureteroscopy, excessive pressure perfusion should be minimized to protect hydronephrosis.
【作者单位】： 武汉大学人民医院泌尿外科;
【基金】：国家自然科学基金资助项目(编号:81200501)
【分类号】：R692.2;R-332
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本文编号：1848619