体外冲击波碎石术对肾细胞内钙水平和肾细胞凋亡的影响

目的探讨体外冲击波碎石术(ESWL)对肾细胞内游离钙([Ca2+]i)水平及肾细胞凋亡的影响与钙通道阻滞剂的干预作用。方法30只家兔制成单肾模型,随机等分为对照组、ESWL组和ESWL+维拉帕米预处理组。ESWL后24h获取肾脏,采用Fura-2/AM荧光指示剂测定肾细胞内[Ca2+]i浓度,原位缺口末端标记法(TUNEL)和流式细胞计数法检测凋亡细胞。结果ESWL组肾细胞内[Ca2+]i增高、肾细胞凋亡率增加(P<0.01);维拉帕米预处理组上述改变明显改善(P<0.01)。ESWL后肾细胞内[Ca2+]i增高与细胞凋亡率有相关趋势(r=0.63,P<0.05)。结论ESWL所致肾细胞内[Ca2+]i超载和肾细胞凋亡增加,可能是ESWL肾损伤的重要机制;钙通道阻滞剂有拮抗细胞内[Ca2+]i超载和肾细胞凋亡增加的作用。

Effects of extracorporeal shock wave lithotripsy on calcium ion level and apoptosis in renal cells

Objective] To observe the effects of extracorporeal shock wave lithotripsy(ESWL)on calcium ion([Ca2+]i) level and apoptosis in renal cells of rabbit and the protective effects of pretreatment with calcium channel blocker on these varieties. [Methods] Thirty healthy male domestic rabbits were surgically managed to the mono-nephron models and randomized into 3 groups consisting of ten each: control group, ESWL group and ESWL plus verapamil pretreatment group. The kidneys from rabbits were obtained 24 hours after ESWL. Renal intracellular [Ca2+]i level was measured by Fura-2/AM fluorescence assay, cell apoptosis was detected by TUNEL(TdT-mediated dUTP Nick End Labelling) and flow cytometry at the same time. [Results] The intracellular [Ca2+]i levels and apoptotic rates increased significantly in ESWL group compared with those in control group (P <0.01). The changes mentioned above were alleviated obviously in ESWL plus verapamil pretreatment group. The intracellular [Ca2+]i levels and apoptotic rates were significantly correlated(r=0.63, P<0.05). [Conclusions] Renal intracellular [Ca2+]i overloading and cell apoptosis increasing may have an important role in the pathologic process of renal injuries induced by ESWL. Calcium channel blocker can hinder these changes.