输尿管部分梗阻与肾小管间质纤维化

Renal fibrosis caused by partial unilateral ureter obstruction

目的:研究单侧输尿管部分梗阻(PUUO)后肾间质纤维化的发生机制及梗阻解除后肾间质纤维化的恢复情况。方法:144只雄性SD大鼠,24只作为对照组,另外120只大鼠建立单侧PUUO动物模型,其中梗阻组24只,在术后1、2、4和8周各随机选取6只,行肾组织病理学检查,免疫组化测定肾间质内Ⅰ型、Ⅲ型胶原蛋白(ColⅠ、ColⅢ);梗阻解除组96只,于梗阻后1、2、4和8周各为24只大鼠解除梗阻,分别于解除后1、2、4和8周各随机选取6只,行病理学观察及免疫组化分析。结果:输尿管部分梗阻后1周,肾间质ColⅠ、ColⅢ表达明显增加(与对照组比较,P<0.01),并随时间延长而逐渐加重(与前一时间段比较,P<0.01)。1、2和4周时解除梗阻,ColⅠ、ColⅢ逐渐恢复,与梗阻解除前比较差异有显著性意义(P<0.01),8周时解除梗阻,胶原蛋白无显著变化。结论:PUUO后肾间质纤维化进行性发展,早期解除梗阻,肾间质纤维化可有不同程度的恢复;若梗阻超过8周,则成为不可逆性改变。

Objective： To investigate the development of tubulointerstitial fibrosis caused by partial unilateral ureter obstruction （PUUO） and the improvement of tubulointerstitial fibrosis after obstruction was relieved. Methods： PUUO was induced by the method of embedding upper half of the ureter into ipsilateral psoas. Obstruction was relieved by dissecting the ureter from psoas groove and returning its normal anatomical position. Pathology examination were performed, and collagen Ⅰ and Ⅲ were semi-quantified by immunohistochemistry assay. Results： Massive accumulation of Type Ⅰ and Ⅲ collagen in tubulointerstitium leads to renal fibrosis. Renal fibrosis can recover if obstruction be relieved within 4 weeks. Conclusion ： The results indicated tubuloinsterstitisl fibrosis develop progressively after PUUO, and fibrosis reduce by obstruction relief.