两种输尿管不全梗阻肾积水动物模型制作方法的比较

Comparison of two different methods to establish animal model of hydronephrosis due to incomplete ureteral obstruction.

目的 比较两种输尿管不全梗阻致肾积水动物模型制作方法的优劣.方法 将10周龄雄性新西兰兔24只随机分为腰大肌组和塑料套管组,每组12只,分别应用腰大肌包埋输尿管法及塑料套管压迫法制作右侧肾盂输尿管连接部梗阻动物模型.模型建立前后10周分别对两组样本行核医学肾动态显像及CT灌注扫描,测得肾小球滤过率（GFR）、肾实质厚度、肾盂前后径、肾皮质及髓质的血容量（BV）、血流量（BF）、平均通过时间（MTY）及表面通透性（PS）等,并以血肌酐、尿素氮、B超及病理检查为佐证,观察两组样本各项参数的变化,进行统计学分析.结果 两组样本右侧肾脏均呈慢性肾积水表现,血肌酐、尿素氮较术前升高,两组右肾GFR、肾实质厚度以及CT灌注参数BV、BF、PS均较术前下降,但套管组下降更为明显（P〈0.05）;两组右肾肾盂前后径较术前增大,套管组增大更为明显（P〈0.05）.结论 两种方法制作肾盂输尿管连接部梗阻模型均具可行性.但塑料套管压迫法制作模型较为稳固,肾积水效果显著,相比于腰大肌包埋输尿管法具有一定的优势,可作为肾积水模型的优先选择方法.

Objective To establish and compare two different methods of hydronephrosis due to uretero- pelvic junction obstruction in rabbit. Methods Twenty-four New Zealand rabbits （ 10-week-old, Male） were randomly assigned to two groups： group A （ 12 rabbits） were embedded the right ureter of ureteropelvic junction under the psoas major muscle and group B （ 12 rabbits） were emboliaed the right ureter of ureteropelvic junction into a plastic cannula. All rabbits were performed both on SPECT and CT perfusion preoperative and postopera- tive respectively, and parameters including GFR, thickness of renal cortical, diameter of pelvis, BV, BF, MTY and PS were assessed and the statistical significance of differences was determined, in terms of BUN,CR, ultrasound result,pathologic diagnoses pathology result and statistical analyses were performed simultaneously on the GFR of SPECT and CT perfusion parameters. Results The success rate of animal model was 83.3% in group A and 91.7% in group B, respectively. All models presented chronic hydronephrosis by pathologically confirmed. BUN and CR of right kidney both group A and group B were increased after operation, Perfusion parameters including BV,BF,PS and GFR of both group A and group B were decreased but rate of decline of group A was more significant than group B （ P 〈0. 05 ）. Both of group showed dilation of renal calyx and pelvis, as well as there was statistically significant difference between the two sets （ P 〈 O. 05 ）. Conclusions Both two method provide highly feasibility for hydronephrosis in rabbit model , but we would recommend method of plastic cannula is the best and first the choice.