本文選題：動物模型 + 腎積水��； 參考：《武漢大學學報(醫(yī)學版)》2015年01期

【摘要】：目的:探討輸尿管套扎法建立兔腎積水模型的可行性及急性壓力灌注對不同程度積水腎腎臟損傷的影響,為臨床經(jīng)皮腎鏡和輸尿管鏡過程中灌注壓力的選擇提供依據(jù)。方法:健康新西蘭大白兔45只,隨機分為正常組(N組,n=5)、輕度積水組(M組,n=20)和重度積水組(S組,n=20)3組。輕度積水及重度積水組模型采用套管法構(gòu)建。輕度積水組與重度積水組分別于結(jié)扎后3,7d行彩色多普勒超聲檢查以判別積水程度。M組和S組隨機分為M0-M3和S0-S3 4個壓力灌注亞組,M0-M3和S0-S3分別行0,20,60,100mmHg壓力灌注,N組行100mmHg壓力灌注。術(shù)后48h取腎臟標本,免疫組化檢測標本中TNF-α及IL-8的表達。結(jié)果:輸尿管套扎法模型構(gòu)建成功率達90%,與正常腎臟相比,結(jié)扎后3d行彩色多普勒超聲檢查,M組可見集合系統(tǒng)分離,有少量液性暗區(qū);結(jié)扎后7d檢查,S組可見集合系統(tǒng)分離明顯,腎皮質(zhì)變薄,液性暗區(qū)占據(jù)腎臟大部分區(qū)域。M組行0,20,60mmHg灌注時IL-8、TNF-α表達量均無明顯變化(P0.05),行100mmHg灌注時IL-8及TNF-α表達量明顯增加(P0.05);S組行0,20mmHg灌注時IL-8、TNF-α表達量均無明顯變化(P0.05),行60,100mmHg灌注時IL-8、TNF-α表達量明顯增加(P0.05);N組行100mmHg灌注時IL-8、TNF-α表達量與M0、S0相比無明顯差別(P0.05)。結(jié)論:輸尿管套扎法建立兔腎積水模型具有可行性,不同程度積水腎對急性壓力灌注的耐受能力不同,高灌注壓力更容易對積水程度重的腎臟造成損傷,在經(jīng)皮腎鏡和輸尿管鏡治療結(jié)石過程中應(yīng)盡量減少過高壓力灌注以保護積水腎臟。
[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- 偽 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- 偽 during perfusion with 0 ~ 20 ~ (60) mmHg in the liquid dark area. The expression of IL-8 and TNF- 偽 in the 100mmHg group was significantly increased, while the expression of IL-8 TNF- 偽 in the 0 ~ (20) mm Hg perfusion group had no significant change. The expression of IL-8 TNF- 偽 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- 偽 in the 60100mmHg perfusion group was significantly higher than that in the control group (0 ~ 20 mm Hg). The expression of IL-8 TNF- 偽 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- 偽 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.
【作者單位】： 武漢大學人民醫(yī)院泌尿外科;
【基金】：國家自然科學基金資助項目(編號:81200501)
【分類號】：R692.2;R-332
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本文編號：1848619