發(fā)布時(shí)間：2018-04-20 01:30

  本文選題：體外沖擊波碎石 + 早期腎損傷��； 參考：《寧夏醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:對(duì)體外震波碎石術(shù)(ESWL)治療的泌尿系結(jié)石患者進(jìn)行碎石前后生化指標(biāo)的檢測(cè),以尋求較好的早期預(yù)測(cè)ESWL腎損傷的生化檢測(cè)指標(biāo),并判斷腎損傷及修復(fù)情況和為兩次ESWL術(shù)的間隔時(shí)間提供實(shí)驗(yàn)室依據(jù)。方法:篩選2014年2月1日到2014年5月31日來(lái)我院治療的60例行ESWL術(shù)的腎結(jié)石患者,分別收集患者術(shù)前及術(shù)后0h,6h,12h,24h,48h,1w,2w尿液標(biāo)本,測(cè)定其尿胱抑素C(Cys C)、尿β2-微球蛋白(β2-MG)、尿α1-微球蛋白(α1-MG)表達(dá),并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:60例患者ESWL術(shù)后各項(xiàng)生化指標(biāo)較術(shù)前均有明顯的變化,且呈現(xiàn)一定的規(guī)律性。胱抑素C在ESWL術(shù)后6小時(shí)出現(xiàn)明顯上升,差異存在統(tǒng)計(jì)學(xué)意義(P0.05),6小時(shí)以后仍然呈上升趨勢(shì),到術(shù)后24h時(shí)到達(dá)最高點(diǎn),相較術(shù)前存在統(tǒng)計(jì)學(xué)意義(P0.05),尿胱抑素C含量在24h以后出現(xiàn)緩慢下降,48h時(shí)的尿胱抑素C水平較術(shù)前仍有統(tǒng)計(jì)學(xué)意義(P0.05),患者術(shù)后1W隨訪的尿胱抑素C的含量已經(jīng)明顯降低,但較術(shù)前水平仍有統(tǒng)計(jì)學(xué)差異(P0.05),術(shù)后2W隨訪時(shí),尿胱抑素C的含量已經(jīng)降至接近術(shù)前水平,較術(shù)前已無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。β2-微球蛋白在術(shù)后24h出現(xiàn)升高,較術(shù)前有統(tǒng)計(jì)學(xué)差異(P0.05),48h時(shí)到達(dá)峰值,然后下降,到術(shù)后1W隨訪時(shí)降至接近正常水平,較術(shù)前無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),2W隨訪時(shí)降至更低水平。α1-微球蛋白也是在術(shù)后24h出現(xiàn)升高,較術(shù)前有統(tǒng)計(jì)學(xué)差異(P0.05),48h達(dá)峰,1W隨訪時(shí)降至正常水平,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:本實(shí)驗(yàn)表明,尿胱抑素C較其它2種指標(biāo)能夠更早的發(fā)現(xiàn)早期腎損傷,并且呈現(xiàn)一定的規(guī)律性,具有較高敏感度,為臨床診治腎損傷提供客觀依據(jù);β2-微球蛋白和α1-微球蛋白也能發(fā)現(xiàn)早期腎損傷,但是敏感性稍差;本研究認(rèn)為術(shù)后2W內(nèi)不宜再次行碎石術(shù)。
[Abstract]:Objective: to detect the biochemical indexes before and after lithotripsy in patients with urolithiasis treated with extracorporeal shock wave lithotripsy (ESWL) in order to find a better biochemical index for early prediction of ESWL renal injury. Renal injury and repair were evaluated and laboratory data were provided for the interval between two ESWL procedures. Methods: 60 patients with renal calculi treated in our hospital from February 1, 2014 to May 31, 2014 were selected. Urine samples were collected from 60 patients with renal calculi before and after operation. The expression of cystatin (C(Cys), 尾 _ 2-microglobulin (尾 _ 2-MGG) and 偽 _ 1-microglobulin (偽 _ 1-MG) in urine were measured and analyzed statistically. Results the biochemical indexes after ESWL in 60 cases were significantly different from those before operation and showed certain regularity. Cystatin C increased significantly at 6 hours after ESWL, and the difference was statistically significant (P 0.05) after 6 hours, and reached the highest point at 24 hours after ESWL. The level of urinary cystatin C decreased slowly after 24 hours. The level of urinary cystatin C at 48 hours after operation was significantly higher than that before operation (P 0.05). The level of urinary cystatin C in the patients followed up 1 week after operation had been significantly decreased. However, there was still significant difference in the level of cystatin C between before and after operation (P 0.05). At the follow-up of 2 weeks after operation, the level of urinary cystatin C had decreased to close to the preoperative level, and there was no significant difference between the two groups before and after operation (P 0.05). 尾 2-microglobulin increased 24 hours after operation. There was a significant difference between the two groups at 48h, then decreased, and then decreased to the normal level at 1W follow-up, which was lower than that at 2W. 偽 1-microglobulin also increased 24 hours after operation. There was a significant difference between the two groups at the end of 48h and the normal level was decreased to the normal level at the end of 48h follow-up. There was no significant difference between the two groups (P 0.05). Conclusion: this experiment shows that urinary cystatin C can detect early renal injury earlier than the other two indexes, and has a certain regularity and high sensitivity. This study provides an objective basis for clinical diagnosis and treatment of renal injury, 尾 2-microglobulin and 偽 1-microglobulin can also detect early renal injury, but the sensitivity is slightly poor.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R692

【共引文獻(xiàn)】

相關(guān)博士學(xué)位論文 前10條

1 楊歡;慢病毒介導(dǎo)中國(guó)人產(chǎn)甲酸草酸桿菌中草酸分解基因FRC和OXC轉(zhuǎn)染肝干細(xì)胞的實(shí)驗(yàn)研究[D];華中科技大學(xué);2011年

2 楊歡;慢病毒介導(dǎo)中國(guó)人腸道產(chǎn)甲酸草酸桿菌中草酸分解基因FRC和OXC轉(zhuǎn)染肝干細(xì)胞的實(shí)驗(yàn)研究[D];華中科技大學(xué);2011年

3 孫衛(wèi)東;動(dòng)物尿石癥的臨床和試驗(yàn)研究[D];南京農(nóng)業(yè)大學(xué);2006年

4 熊瑋;α1腎上腺素受體阻滯劑用于輸尿管結(jié)石排石治療[D];四川大學(xué);2007年

5 黎承楊;草酸和草酸鈣晶體誘導(dǎo)腎臟NADPH氧化酶相關(guān)性氧化應(yīng)激損傷的研究[D];廣西醫(yī)科大學(xué);2009年

6 畢小麗;益氣溫陽(yáng)通痹法治療糖尿病合并冠心病的臨床觀察及對(duì)Cys C的影響[D];廣州中醫(yī)藥大學(xué);2009年

7 喬建坤;VKDC/VKOR在草酸鈣尿石形成過(guò)程中的作用及分子機(jī)制的初探[D];華中科技大學(xué);2009年

8 朱晨曦;維生素D受體與特發(fā)性低枸櫞酸尿癥之間關(guān)系的研究[D];華中科技大學(xué);2010年

9 朱光斌;DECT對(duì)尿結(jié)石化學(xué)成分分析的實(shí)驗(yàn)和臨床應(yīng)用研究[D];南方醫(yī)科大學(xué);2010年

10 孔德波;中國(guó)人腸道產(chǎn)甲酸草酸桿菌甲酰輔酶A轉(zhuǎn)移酶和草酰輔酶A脫羧酶基因的克隆及其在真核細(xì)胞中的表達(dá)研究[D];華中科技大學(xué);2007年

，

本文編號(hào)：1775653