【摘要】 目的探讨体外冲击波碎石(ESWL)对肾结石患者血清肿瘤坏死因子的影响及可能的机制。方法选择经X线或CT结合腹部B超确诊为肾结石无症状患者30例,观察体外冲击波碎石对肾结石患者血清肿瘤坏死因子(TNFα)的影响及尿N-乙酰-β-葡萄糖苷酶(NAG)和γ-谷氨酰胺转肽酶(γ-GT)、β2-微球蛋白(β2-MG)的变化。结果ESWL后血清TNFα值迅速升高,24 h达最高值(P<0.05),1周时仍高于碎石前水平(P<0.05)。尿NAG值逐渐升高,24 h达高峰(P<0.05),1周降至ESWL前水平(P>0.05);尿γ-GT值逐渐升高,24 h达高峰(P<0.05),72 h降至ESWL前水平(P>0.05);尿β2-MG值迅速达高峰(P<0.05),24 h降至ESWL前水平(P>0.05)。结论ESWL导致肾结石患者血清TNFα水平升高,并与肾小管上皮细胞功能损伤相关。更多还原

【Abstract】 Objective To study the effects of extracorporeal shock wave lithotripsy on serum TNFα levels in patients with renal calculus.Methods Thirty patients with renal calculus,who were diagnosed to have asymptomatic kidney stones by X-ray or CT combined with abdominal B-Ultrasound,underwent the initial extracorporeal shock wave lithotripsy(ESWL) treatment.The ESWL serum TNFα,urinary NAG,γ-GT and β2-MG were measured before and after the treatment.The indexes were also measured in 30 healthy control subjects 23 to 65 years old(mean age 35.6 years).Results After ESWL treatment,serum TNFα,related to renal injury and renal tubular inflammatory,showed a significant increase and maintained at a high level for more than one week(P<0.05).At the same time,urine enzyme activities,γ-GT and NAG reached the highest levels after 24 hours(P<0.05),and decreased to baseline one week after the treatment(P>0.05).Urine β2-MG levels reached the highest levels immediately(P<0.05),and decreased to baseline after 24 hours(P>0.05).Conclusion These results demonstrate that extracorporeal shock wave lithotripsy plays an important role in increasing serum TNFα related to renal tubular injury.更多还原