体外冲击波致狗肾损伤的病理形态学研究

Morphological Changes in Trauma of Canine Kidneys after Exposure to Extracorporeal Shock Waves

对24条狗肾脏进行体外冲击波实验,电压10～12KV,冲击波2000次,而后以每组4条随机分6组,分别于冲击波致伤后立即、第3日、1周、1月、3月和6月时取肾活检。光镜显示急性损伤典型改变分为中心出血、变性坏死及外周反应三个区。电镜示肾小体血管内皮细胞破裂、线粒体肿胀、肾曲管上皮细胞核染色质浓缩、边集。病理形态学观察结果提示:体外冲击波可引起肾脏不同程度损伤,其不可逆损伤及远期影响尚待进一步研究。

The changes of extracorporeal shock wave lithotripsy (ESWL) to renal morphology were studied by light and electron microscopy in 24 dogs. One kidney received 2000 shock waves at 10—12KV. The animals were sacrificed at a period of immediation, 3 days, 1 week. 1.3 and 6 months after ESWL induced trauma. Bilateral nephrectomy was performed. Resulted injury was observed in all exposed kidneys, representing central bleeding, degeneration and necrosis, and reaction in peripheral zone of the parenchyma in acute stage under light microscopy. There were the rupture of endothelia of renaleorpuscles vessel, the swelling of mitochondria and the concentration of nuclear chromatin of renal tubular epithelial cell under electronmicroscopy. Some of these alterations were irreversible, and its long term effects of function on kidneys is unknown.