体外震波碎石前后血浆和尿液PGI_2与TXA_2的变化及其临床意义

Acute changes and clinical significance ofPG12 and TXA2 in plasma and urine following ESWL in patients With nephrolithiasis

应用放射免疫技术，对１４例非梗阻性单纯肾结石患者ＳＥＷＬ前后血浆和尿液中ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１ａ水平进行了动态检测。结果显示，血浆ＴＸＢ２在ＥＳＷＬ后第一天明显升高（Ｐ＜０．００１），而６－ｋｅｔｏ－ＰＧＦ１α无显著意义的改变（Ｐ＞０．０５），两者的比值也随ＴＸＢ２而升高（Ｐ＜Ｏ．００１），第三天时都降至基础水平；尿液中上述指标也出现类似变化。我们认为，ＥＳＷＬ后早期肾脏内ＴＸＡ２合成与释放增加，ＴＸＡ２与ＰＧＩ２平衡失调，有可能参与了肾损害的病理生理过程。

Plasma and urine levels of TXB2 and 6-keto-PGF1a(the stable metabolites of TXA2and PG12)were measured in 14 patients suf-fering from unilateral nonobstructivenephrolithiasis before,thirty minutes, day 1and day 3 after shock wave treatment by a ra- dioimmunoassay. It was found that plasma lev- els of TXB2 increased significantly at day 1 af-ter treatment compared with the levels of pre-treatment(P<0.001),and 6-keto-PGF1 aplasma levels remained unchanged.The rationof TXB2/6-keto-PGF1 a also significantly in- creased at day 1 post-ESWL. Compaired withthe values of pre-ESWL(P<0.001). Thesame was true in the urinary levels of TXB2and 6-keto-PGF1a sfter ESWL. We concludedthat the regional metabolitic disorder of TXA2in treated kidney has occurred. The balance ofTXA2 and PGI2 has lost immediately afterESWL. These changes may act as contrbutorymechanism for pathophysiological procedureof kidney injury in ESWL.