维拉帕米对ESWL所致肾损伤保护作用的实验研究.docVIP

维拉帕米对ESWL所致肾损伤保护作用的实验研究 　　作者：姜华茂，郭敏，张春阳，李晨光，张大田 作者单位：(辽宁医学院附属第一医院泌尿外科，辽宁 锦州121001) 　　【摘要】 目的 建立家兔体外冲击波致伤模型，探讨维拉帕米对ESWL所致肾损伤的作用。方法 家兔24只，随机分为对照组和维拉帕米组，每组12 只，以体外冲击波(12KV·2000次)致伤，致伤前15 min分别静脉注射生理盐水和人参总皂甙，术后24 h测定肾脏出血组织体密度和被膜下出血面积及尿Γ-GT/Cr、IgG/Cr的水平，并进行病理观察。结果 维拉帕米组尿Γ-GT、IgG的水平低于对照组，与对照组比较维拉帕米组肾脏出血组织体密度和被膜下出血面积明显减小。病理观察示2组肾脏皆出现不同程度损伤。结论 维拉帕米可减轻ESWL所致家兔肾损伤。 　　【关键词】 维拉帕米;体外冲击波碎石术;肾损伤 　　Experimental Study on Protective Effect of Verapamil on ESWL Induced Renal DamageJIANG Huamao, GUO Min, ZHANG Chunyang, LI Chenguang, ZHANG Datian 　　(Department of Urology, the First Affiliated Hospital of Liaoning Medical University, Jinzhou 121001 China)Abstract: Objective to study the effect of verapamil on renal damage induced by extracorporeal shock wave lithotripsy (ESWL) in renal injury models of rabbits. Methods 24 rabbits were randomly divided into the verapamil group and the control group, 12 in each group, and they were treated with intravenous injection of verapamil and saline respectively,15 minutes later, they were given the extracorporeal shock wave lithotripsy. The urinary Γ-GT/Cr, IgG/Cr and the volume of renal hemorrhagic tissue and hemorrhagic area under renal fascia were measured 24 hours after ESWL. Results In the verapamil group, there was a significant decrease in the urinary Γ-GT/Cr, IgG /Cr volume density of renal hemorrhagic tissue and hemorrhagic area under renal fascia compared with the control group after ESWL. We observed renal injury in different degree in rabbits 24 hours after ESWL. Conclusions Verapamil has protective effects on renal injury induced by shock wave in rabbits. 　　Key words: verapamil; extracorporeal shock wave lithotripsy; renal injury 　　体外冲击波碎石术(Extracorporeal shock wave lithotripsy,ESWL)现已成为上尿路结石患者的首选治疗方案, 随着ESWL的广泛应用，冲击波对肾脏的损伤引起了人们的重视[1]。冲击波所致肾损伤与物理损伤、缺血再灌注损伤和氧自由基损伤等有关。钙拮抗剂具有抗自由基脂质过氧化损伤，保护细胞膜功能等作用。本研究制作了ESWL致肾损伤的家兔模型，通过测定肾脏出血组织体密度和被膜下出血表面积及尿Γ-GT/Cr、IgG/Cr的水平，探讨维拉帕米对ESWL所致肾损伤的保护作用。 　　1 材料和方法 　　1.1 主要试剂和仪器