本文選題：美樂(lè)托寧 + UPJO�。� 參考：《福建醫(yī)科大學(xué)》2014年碩士論文

【摘要】：【目的】探討美樂(lè)托寧對(duì)慢性不完全性腎盂輸尿管連接處梗阻（UPJO）兔輸尿管組織誘導(dǎo)型一氧化氮合酶（iNOS）的影響和意義。 【方法】成年新西蘭兔32只，雌雄不限，隨機(jī)分成4組，每組8只，正常組A，假手術(shù)組B，手術(shù)組C，手術(shù)+藥物組D；A組不做任何處理，B、C、D組均行開腹手術(shù)暴露左側(cè)腎盂輸尿管連接處，B組不做任何處理后關(guān)腹，C、D組手術(shù)制作UPJO模型。造模成功后，所有兔子均給予清水和普通飼料喂養(yǎng)，D組于術(shù)前1周及術(shù)后加用美樂(lè)托寧喂養(yǎng)至實(shí)驗(yàn)結(jié)束。術(shù)前、術(shù)后第1、2、4、8周行靜脈腎盂造影（IVP）了解尿路梗阻情況，同時(shí)于術(shù)后1、2、4、8周開腹行術(shù)側(cè)梗阻處尿一氧化氮（NO）濃度檢測(cè)，隨后取梗阻處輸尿管組織行HE染色觀察其結(jié)構(gòu)病理變化并采用免疫組化檢測(cè)iNOS的表達(dá)情況。 【結(jié)果】1、IVP：C組術(shù)后第1周出現(xiàn)腎積水，D組術(shù)后第4周出現(xiàn)腎積水，嚴(yán)重程度均隨術(shù)后時(shí)間推移而加重；C組顯影時(shí)間明顯長(zhǎng)于A、B、D組(P0.05)，且隨術(shù)后時(shí)間推移而增加；術(shù)后第4周開始，D組顯影時(shí)間明顯長(zhǎng)于A、B組(P0.05)，且隨術(shù)后時(shí)間推移而增加。2、梗阻處尿NO濃度：C、D組尿NO濃度均明顯高于A、B組(P0.05)，且隨術(shù)后時(shí)間推移而增高；D組尿NO濃度明顯低于C組(P0.05)。3、梗阻處輸尿管組織HE染色：A、B組輸尿管各層結(jié)構(gòu)基本正常；C組黏膜層呈炎癥增生改變，平滑肌層結(jié)構(gòu)紊亂，大量纖維組織增生；D組病變介于A、B組和C組之間。4、梗阻處輸尿管組織免疫組化：iNOS主要表達(dá)于輸尿管平滑肌層，各組表達(dá)程度依次為：CDBA (P0.05)；C組表達(dá)程度隨術(shù)后時(shí)間推移而增強(qiáng)；D組表達(dá)程度于術(shù)后第4周開始隨術(shù)后時(shí)間推移而增強(qiáng)。 【結(jié)論】1、UPJO梗阻處iNOS表達(dá)及尿NO濃度明顯增加，且均隨梗阻程度加重而增加，尿NO可能可以作為判斷梗阻程度指標(biāo)，有潛在臨床應(yīng)用價(jià)值。2、iNOS與尿NO參與UPJO致腎積水的病理過(guò)程，，與腎功能損害密切相關(guān)。3、美樂(lè)托寧可能通過(guò)抑制iNOS的過(guò)度表達(dá)從而減少NO的產(chǎn)生，降低尿NO濃度，減緩氧化損傷作用，減輕梗阻處輸尿管組織的病理改變，從而改善腎積水，保護(hù)腎功能。
[Abstract]:[objective] to investigate the effect and significance of melatonin on ureteral tissue inducible nitric oxide synthase (iNOS) in rabbits with chronic incomplete ureteropelvic junction obstruction (UPJO). [methods] Thirty-two adult New Zealand rabbits, male and female, were randomly divided into 4 groups with 8 rabbits in each group. Normal group A, sham operation group B, operation group C, operation drug group D group without any treatment, group D all underwent open operation to expose left pelvis and ureteral junction, group B did not do any treatment, then closed abdomen to make UPJO model. All rabbits were fed with clear water and common feed for 1 week before operation and after operation with melatonin until the end of the experiment. Before operation, intravenous pyelography (IVP) was performed 8 weeks after operation, and urinary nitric oxide (no) concentration was detected at 1, 2, 4 and 8 weeks after operation. The ureteral tissues were stained with HE and the expression of iNOS was detected by immunohistochemistry. [results] 1in group C, hydronephrosis occurred at the first week after operation. The severity of hydronephrosis in group D was significantly longer than that in group A (P 0.05) and increased with time after operation. From the 4th week after operation, the development time of group D was significantly longer than that of group A B (P 0.05), and increased with the passage of time. The concentration of no in group D was significantly higher than that in group A B (P 0.05), and the concentration of no in group D was significantly higher than that in group A (P 0.05). It was significantly lower than that in group C (P 0.05). The ureteral tissue in the obstruction was stained with HE in the ureteral tissue. The ureteral layers in group B were basically normal and the mucosal layer in group C showed inflammatory hyperplasia. The structure of smooth muscle layer was disordered, the pathological changes of group D were between group A B and group C, and the pathological changes of group D were between group A B and group C. the immunohistochemical staining of the ureteral tissue was mainly expressed in the smooth muscle layer of ureter. The degree of expression in group C was increased with the passage of time after operation. The expression level of group D increased with the passage of time from the 4th week after operation. [conclusion] 1 the expression of iNOS and the concentration of no in urine increased significantly in the obstructive site of UPJO, and both of them increased with the severity of obstruction. Urinary no may be used as an index to judge the degree of obstruction, and it has the potential clinical application value of .2iNOS and no in the pathological process of hydronephrosis induced by UPJO. Melatonin may reduce the production of no, decrease the concentration of no in urine, reduce the effect of oxidative injury, alleviate the pathological changes of ureteral tissue in obstruction, and improve hydronephrosis by inhibiting the overexpression of iNOS. Protect renal function.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R693.2


本文編號(hào)：1788585