ESWL术后肾脏及尿路上皮损害程度的临床研究.docVIP

ESWL术后肾脏及尿路上皮损害程度的临床研究 　　【摘要】 目的：通过研究体外冲击波碎石（ESWL）后肾脏及尿路上皮细胞损害程度的变化，从而评估碎石的安全性及安全间隔时间。方法：选取输尿管腹段结石应用ESWL治疗的患者，分别记录患者的基本资料，包括年龄、性别、结石大小、病程、位置、X线及肾积水程度等方面，常规留取碎石前、碎石后1、5、7 d的尿液，进行细胞学检查。取患者的尿液进行离心后，在显微镜的40倍的目镜下分别观察尿路上皮细胞、红细胞、肌细胞，取5个视野分别进行记数，取平均值，以及血清β2-微球蛋白（β2-MG）及尿微量白蛋白的评估。结果：碎石后1 d尿路上皮细胞、红细胞、血清微球蛋白（β2- MG）及尿微量白蛋白（MCA）在碎石后显著升高，5～7 d后逐渐恢复正常。镜下未检测到肌细胞，肾功能Cr、BUN无明显变化。结论：通过联合测定尿路上皮细胞、红细胞、肌细胞，以及β2-微球蛋白及尿微量白蛋白，对评估ESWL术后尿路上皮及肾功能损伤具有重要价值，ESWL局限于黏膜层，没有损坏基底膜或深肌层，对输尿管造成轻微的损伤，并且对肾功能损害是暂时性，并且可为再次行输尿管结石ESWL术提供合理的间隔时间参考。 　　【关键词】 输尿管结石； ESWL； 尿细胞学检测 　　中图分类号 R691.4 文献标识码 B 文章编号 1674-6805（2016）29-0015-02 　　The Study of the Degree of the Kidney and Urinary Tract Epithelial Cell Damage Change after ESWL/LIN Yun-qiao，YE Jing-jing，CHEN Cong-qi，et al.//Chinese and Foreign Medical Research，2016，14（29）：15-16 　　【Abstract】 Objective：To assess the safety of gravel and the security of interval period，through the study of the degree of the kidney and urinary tract epithelial cell damage change after extracorporeal shock wave lithotripsy（ESWL）.Method：Patients with the ESWL treatment of abdominal segment ureteral calculi were recorded with basic information，including age，sex，stone size，duration，location，X-ray and hydronephrosis level and other aspects of conventional specimens gravel，crushed stone after 1 d，5 d，7 d urine cytology.After centrifuging the patient’s urines，their urothelial cells，red blood cells，muscle cells were observe，separately under an Eyepiece 40 times Microscope.Them separately under the five different visions were counted.And then the average and the assessment of the serum β2-microglobulin（β2-MG） and the urinary micro albumin were taken.Result：After ESWL，urothelial cells，red blood cells，serum microglobulin（β2- MG） and microalbuminuria（MCA） were significantly higher after 1 d，and gradually returned to normal after 5-7 d.Muscle cells，kidney function Cr，BUN were not significantly changed under the microscopic inspection.Conclusion：The combined determination of urinary trac