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目的探讨肾盂输尿管连接部(UPJ)梗阻对对侧肾的影响。方法采用新西兰大白兔24只,随机分为完全梗阻组(组1)、部分梗阻组(组2)和假手术组(组3),每组8只。组1、2分别行右侧输尿管完全、部分结扎,组3只显露而不结扎输尿管。术后4周处死,切除对侧肾。处死前尿路造影示组1、2兔均发生右侧肾积水。应用电子天平测定对侧肾实质重量,采用FITC-Annexin-V/PI双染色流式细胞仪检测对侧肾皮髓质细胞凋亡率。所有标本均行病理学检查。结果4周后,组1、2、3对侧肾实质重量分别为(3.96±0.20)、(3.47±0.19)、(3.20±0.21)g/kg体重,组1、2与组3比较差异均有统计学意义(P<0.05);对侧肾皮质的细胞凋亡率分别为(2.19±0.83)%、(2.17±0.79)%和(2.14±0.76)%,组间两两比较差异均无统计学意义(P>0.05);对侧肾髓质的细胞凋亡率分别为(23.75±2.34)%、(11.82±1.40)%和(2.36±0.65)%,组间两两比较差异均有统计学意义(P<0.01)。UPJ梗阻4周后,组2对侧肾间质充血、轻度水肿,部分肾小管扩张,管腔内存在坏死脱落的物质;组1对侧肾改变更为明显。结论UPJ梗阻不仅引起对侧肾实质代偿性增生,同时还造成对侧肾损害。
Objective To investigate the effect of ureteropelvic junction (UPJ) obstruction on the contralateral kidney. Methods Twenty-four New Zealand white rabbits were randomly divided into complete obstruction group (group 1), partial obstruction group (group 2) and sham operation group (group 3), with 8 in each group. Groups 1 and 2, respectively, right ureter complete, partial ligation, group 3 revealed without ligating the ureter. After 4 weeks, the contralateral kidney was resected. Before the death of urinary tract angiography showed 1,2 rabbits have occurred on the right hydronephrosis. The contralateral renal parenchyma weight was measured by electronic balance. The apoptosis rate of contralateral renal cortex and medulla was detected by FITC-Annexin-V / PI double staining flow cytometry. All specimens underwent pathological examination. Results After 4 weeks, the contralateral renal parenchymal weights of groups 1, 2 and 3 were 3.96 ± 0.20, 3.47 ± 0.19 and 3.20 ± 0.21 g / kg, respectively (2.19 ± 0.83)%, (2.17 ± 0.79)% and (2.14 ± 0.76)% respectively in the contralateral renal cortex, there was no significant difference in any two groups (23.75 ± 2.34)%, (11.82 ± 1.40)% and (2.36 ± 0.65)% respectively in the contralateral medulla. There was significant difference between the two groups Statistical significance (P <0.01). After 4 weeks of UPJ obstruction, contralateral renal interstitial hyperemia, mild edema, and partial tubular dilatation were found in group 2, with necrotic substances in the lumen. Contralateral renal changes were more obvious in group 1. Conclusion UPJ obstruction not only causes contralateral renal parenchymal compensatory proliferation, but also cause contralateral kidney damage.