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-  2015 

急性压力灌注对不同程度肾积水模型兔肾脏的损伤 Renal Damages Induced by Various of Irrigation Pressures in Rabbits with Mild or Severe Hydronephrosis

Keywords: 动物模型,肾积水,灌注压力,损伤

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Abstract:

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(P>0.05),行100mmHg灌注时IL-8及TNF-α表达量明显增加(P<0.05);S组行0,20mmHg灌注时IL-8、TNF-α表达量均无明显变化(P>0.05),行60,100mmHg灌注时IL-8、TNF-α表达量明显增加(P<0.05);N组行100mmHg灌注时IL-8、TNF-α表达量与M0、S0相比无明显差别(P>0.05)。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

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