单侧输尿管梗阻对对侧肾小管上皮细胞凋亡影响的研究

目的探讨单侧输尿管梗阻对对侧肾小管上皮细胞凋亡的影响。方法新西兰大白兔48只,随机建立右侧输尿管完全梗阻4周和8周组;部分梗阻4周和8周组;假手术4周和8周组动物模型,每组8只。分别于梗阻4周、8周时取对侧肾脏,称重后利用TUNEL法检测对侧肾小管上皮细胞凋亡,并行HE染色。结果梗阻4周、8周均引起对侧肾实质代偿性增生,与梗阻程度及时间正相关（P〈0.05）。梗阻4周组HE染色见少数肾小管扩张,腔内存在坏死脱落细胞,以完全梗阻明显,但8周较4周相应各组无明显变化。TUNEL法检测完全梗阻、部分梗阻及假手术4周组对侧近曲小管上皮细胞凋亡指数分别为（6.02±1.21）%、（3.87±1.70）%、（2.32±1.39）%;远曲小管上皮细胞凋亡指数分别为（12.08±2.33）%、（7.22±3.35）%、（3.38±2.34）%;8周组对侧近曲小管上皮细胞凋亡指数分别为（7.00±2.19）%、（4.47±2.11）%、（2.29±0.85）%;远曲小管上皮细胞凋亡指数分别为（13.02±3.16）%、（8.11±2.99）%、（3.63±1.96）%。相应各组组间比较均有统计学意义（P〈0.05）,但8周与4周相应各组比较均无统计学意义（P〉0.05）。结论单侧输尿管梗阻早期可引起对侧肾小管上皮细胞损害,但随梗阻时间的延长并未进一步加重。

Effects of unilateral ureteral obstruction on the apoptosis of contralateral renal tubular epithelial cell

Objective To explore the effects of unilateral ureteral obstruction on the apoptosis of epithelial cells of the opposite nephric tubule.Methods 48 New Zealand rabbits were randomly divided into six groups with 8 rabbits in each group: 4-week and 8-week complete right ureteral obstruction groups,4-week and 8-week partial right ureteral obstruction groups,4-week and 8-week sham-operated normal controls.The contralateral renal weight was measured with electron balance and the apoptosis of epithelial cells of the opposite nephric tubule was studied with TUNEL and HE the 4th and 8th week after operation.Results Compensatory hyperplasia of the opposite renal parenchyma could be observed in the 4th week(P<0.05),and more obvious in the 8th week(P<0.05),with significant differences between complete and partial groups(P<0.05).4-week ureteral obstruction showed histologic alterations in the contralateral kidney: a few epithelial cells dilated tubuli with necrotic deposits inside,which was more obvious in the complete obstruction groups.However,there was no significant difference between the 4-week and 8-week groups.The TUNEL showed that the apoptosis rates of proximal convoluted tubule and distal convoluted tubule in the 4-week complete obstruction group,4-week partial obstruction group and 4-week normal controls were(6.02±1.21)% and(3.87±1.70);(2.32±1.39)% and(12.08±2.33)%;and(7.22±3.35)% and(3.38±2.34)%,with significant differences between the groups(P<0.05).The apoptosis rates of proximal convoluted tubule and distal convoluted tubule in the 8-week complete obstruction group,8-week partial obstruction group and 8-week normal controls were(7.00±2.19)% and(4.47±2.11)%;(2.29±0.85)% and(13.02±3.16)%;and(8.11±2.99)% and(3.63±1.96)%,with significant differences between the groups(P<0.05).Conclusions Unilateral ureteral obstruction could cause damage in the epithelial cells of the opposite nepheric tubule in the early stage,but the effect won’t worsen as time prolongs.