不同冲击波源及次数致家兔肾损伤比较探究.docVIP

不同冲击波源及次数致家兔肾损伤比较探究 　 作者：罗晓辉　陈兴发　薛玉泉　王新阳　贺大林　汤正岐 【摘要】 　　目的 探讨不同冲击波源及冲击次数对肾损伤的差异。方法 40只健康雄性家兔，按波源分为电磁组和液电组，分别冲击1000次、1500次分为A、B亚组。冲击前、后不同时间测定血清黄嘌呤氧化酶(XOD)、谷胱甘肽过氧化物酶(GSHPX)、抗超氧阴离子自由基，并观察肾脏组织学变化。结果 各组血清XOD冲击后即刻升高，72h达峰值(Plt;0.01)，14d降至正常水平。GSHPX、抗超氧阴离子自由基于冲击后24h明显下降，72h降至最低值(Plt;0.01)，2周后恢复冲击前水平。A亚组各指标在冲击后24h至7d与B亚组有显著性差异(Plt;0.01)；液电及电磁冲击波源之间各指标未见显著性差异。组织学改变在冲击后24h至72h表现损伤最为显著，14d后基本恢复正常。结论 冲击波导致的肾损伤程度与冲击次数呈正相关，在保证碎石效果的前提下控制冲击次数可有效减轻肾损伤。液电和电磁两种冲击波源导致肾损伤程度无明显差异。 【关键词】 体外冲击波碎石术　冲击波源　肾损伤　家兔 　　Comparitive study of renal damage induced by shack wave of different SW sources and shocks in the rabbits 　　　ABSTRACT: Objective To compare the renal damage caused by an electro hydraulic and an electromagnetic SW source, with 1500 and 1000 shocks. Methods 40 healthy male rabbits were randomly divided into two groups: electromagnetic lithotripter group (20 rabbits) and electrohydraulic lithotripter group (20 rabbits); each group was divided into two subgroups: A group (1000 shocks) and B group (1500 shocks). XOD, GSHPX and antisuper oxide anion radical in serum were detected before and after ESWL at various times. At the same time the histopathology of the kidney tissues were observed. Results Serum XOD, related to renal injury, changed obviously immediately and reached the peak value at 72 hours after shocks (Plt;0.05). The value decreased on 7th day and recovered after 14 days. Serum GSHPX and antisuper oxide anion radical decreased significantly at 24 hours and reached the minimum at 72 hours after shocks (Plt;0.05). The value increased after 1 week and recovered after 14 days. After shock, the data in groupA (1000 shocks) was significantly different from that in groupB (1500 shocks) (Plt;0.01). The change of data between an electrohydraulic and an electromagnetic SW source was not significant. The histopathology of the kidney tissues changed significantly at 24 and 72 hours and recovered after 14 days. Conclusion Renal damage induced by the highenergy shock wave