大鼠急、慢性梗阻性积水肾组织的形态学改变

目的:比较急、慢性梗阻性肾积水大鼠时序性肾脏形态结构的病理变化。方法:选择SD大鼠(n=54),随机分为急性输尿管梗阻模型组(n=18)、慢性输尿管梗阻模型组(n=18)和正常对照组(n=18)。应用肉眼观、常规显微镜和扫描电子显微镜技术分别于建模后24h、48h、1周、3周、4周、6周不同时间点,观察急、慢性梗阻性肾积水肾脏组织的形态学改变。结果:通过肉眼观、HE染色常规镜下观以及扫描电镜动态观察发现急、慢性梗阻性肾积水组织早期形态学改变主要为炎性细胞的浸润以及肾小管管腔的扩大随梗阻时间的迁延而逐渐加剧,但慢性梗阻组的改变在程度和时间方面明显较急性梗阻组滞后。当病理进程进入中后期时,即急性梗阻3周和慢性梗阻4周时,两组的形态学改变在程度和时间上才趋于一致,均为炎性细胞消退、纤维组织广泛增生以及肾小管管腔塌陷。结论:大鼠急、慢性梗阻性肾积水在早期形态结构改变有较大不同,但在急性梗阻性肾积水3周后其超微结构变化与慢性梗阻性肾积水4周后的超微结构基本趋于一致。鉴于急性输尿管梗阻动物模型建模简单方便、易于规范、经济实用等特点,采用急性梗阻性肾积水动物模型在一定时间段替代慢性梗阻性肾积水动物模型研究梗阻性肾积水纤维化变化规律具有可行性。

Morphological Changes in Kidney of Rat Acute and Chronic Obstructive Hydronephrosis

Objective:To explore the morphological changes in the renal structure of acute and chronic hydronephrosis of rat. Methods: Adult SD rats (n=54) were randomly and equally divided into three groups as sham operated group, acute and chronic hydronephrosis groups. By gross observation and under optical microscope after HE staining and scanning electron microscope, the morphological changes in the structure of acute and chronic hydronephrosis kidney were observed after 24 hours, 48 hours, and 1, 3, 4, 6 weeks. Results: At the early stage after obstruction, infiltration of inflammatory cells and dilating of tubules were observed both in the acute and chronic groups, but the changes in chronic group were milder and later. At the middle and late stages, acute group (after 3 weeks) and chronic group (after 4 weeks) had similar changes as decreased inflammatory cells, enlarged interstitial space, and collapsed renal tubules. Conclusion: The changes of renal structure are different between the acute and chronic hydronephrosis groups in the early period, but the changes are similar after 3 weeks of acute hydronephrosis and after 4 weeks of chronic hydronephrosis. The acute rat model of hydronephrosis could be used for the study of chronic obstructive hydronephrosis in certain stages.