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目的 探讨拮抗内皮素 (ET)在体外冲击波碎石术 (ESWL)致肾脏急性损伤中的防治作用。 方法 6 0例行ESWL治疗的肾盏、肾盂内结石患者 ,随机分为硝苯地平组和对照组 ,各 30例。硝苯地平组在ESWL前 3d口服药物 ,对照组不服用任何药物。 2组分别于ESWL治疗前 1d、后 1d、后 1周采用放射免疫法测定血浆ET ,同时测定 2 4h尿微球蛋白 (β2 M )、TH糖蛋白 (TH P)等变化。 结果 ESWL后对照组ET、β2 M均明显高于治疗前 (P <0 .0 0 1) ,尿TH P则明显低于治疗前水平(P <0 .0 0 1) ,差别有显著性意义。硝苯地平组ESWL后ET、β2 M均比治疗前增加 ,尿TH P降低 ,但差别均无显著性意义 (P >0 .0 5 )。 结论 硝苯地平能够拮抗ESWL致急性肾脏损害患者的血浆内皮素 ,对ESWL导致的急性肾功能损害有保护作用
Objective To investigate the preventive and therapeutic effects of endothelin (ET) in acute renal injury induced by extracorporeal shock wave lithotripsy (ESWL). Methods Sixty patients with renal calyx and pyelolith calculi treated with ESWL were randomly divided into nifedipine group and control group, with 30 cases in each group. Nifedipine group ESWL oral administration of the first 3 days, the control group did not take any drugs. The plasma ET was measured by radioimmunoassay at 1 day, 1 day and 1 week after ESWL treatment respectively. The levels of 24 hours urinary microglobulin (THP) and THP were also measured. Results After ESWL, the levels of ET and β2 M in the control group were significantly higher than those before treatment (P0.01), while the levels of THP in the urine were significantly lower than those before treatment (P0.01), the difference was significant . Nifedipine group ESWL after ET, β2 M increased compared with before treatment, urinary TH P decreased, but the difference was not significant (P> 0.05). Conclusion Nifedipine is able to antagonize the plasma endothelin level in ESWL-induced acute kidney injury and protect ESWL-induced acute renal impairment