逐步提高冲击波能量预处理对体外冲击波碎石术肾损伤的保护作用

目的探讨逐步提高冲击波能量（GESW）预处理对体外冲击波碎石术（ESWL）肾损伤的保护作用及机制。方法制成单肾的40只雌性家兔随机等分为对照组、GESW组、ESWL组、ESWL＋GESW预处理组。GESW组肾接受300次GESW；ESWL组肾接收标准的1500次ESWL：ESWL＋GESW预处理组先按GESW组处理，然后同ESWL组处理。24h时观察肾组织超氧化物歧化酶（SOD）活性、丙二醛（MDA）含量和尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）变化，原位缺口末端标记法（TUNEL）检测凋亡细胞。结果与ESWL组比较，GESW预处理组肾组织SOD活性增高（P〈0．05），MDA含量和细胞凋亡指数降低（P〈0．01）、尿NAG降低（P〈0．01）。与对照组比较，GESW组各项指标差异无统计学意义（P〉0．05）。结论GESW预处理可减轻ESWL所致的肾损害，与其抗氧化应激损伤、抗细胞凋亡有关。

Prevention of extracorporeal shock wave lithotripsy -induced renal injury by pretreating kidneys with gradually enhancing-energy shock waves

Objective To investigate the prevention and its mechanism of extracorporeal shock wave lithotripsy （ESWL） -induced renal injuly by pretreating kidneys with gradually enhancing -energy shock waves （GESW） Method Forty healthy female domestic rabbits were surgically managed to be the mono- nephron models and randomized into 4 groups consisting of ten each： control, GESW, ESWL and ESWL plus GESW pretreated groups. GESW group received 300 GESW;ESWL group received 1500 standard ESWL;and same as ESWL group except 300 GESW pretreatment in ESWL plus GESW pretreated group. The rabbit kidney tissues were obtained 24 hours after ESWL. Activity of superoxide dismutase （SOD） and malondialdehyde （MDA） levels in the renal tissue, and the level of N-acetyl-β - D-glucosaminidase（NAG） in urinary were measured. Renal cell apoptosis was detected by TdT-mediated dUTP Nick End Labelling （TUNEL）. Results The MDA, the urinary level of NAG and rate of apoptosis in the GESW groups were reduced （P〈0.01）, and the activity of SOD increased significantly （P〈0.05）as compared with ESWL group, and these changes in GESW group had no statistics difference compared with the control group, （P〉0.05）. Conclusions It is concluded that the GESW pretreatment protocol substantially limits the renal injury that is caused by ESWL usually, GESW may suppress oxidative stress and antagonize the process of renal cellular apoptosis.