碎石术对肾结石患者肾功能损害的观察

The function of kinney damage in patient with kidney stone by extracorporeal shock wave lithotripsy method

目的 探讨肿瘤坏死因子-α（TNF-α）和表皮生长因子（EGF）在经尿道体外冲击波碎石术（ESWL）的变化和规律。方法采用放射免疫分析法，选择性地对50例肾单发结石患者ESWL前后TNF-α和EGF含量进行测定。结果碎石后尿中TNF-α含量在1～4d与术前比较总体水平明显升高（t=2．22，P〈0．05），术后2d TNF-α含量明显高于术后4d（t=2．82，P〈0.01），第5天水平回落，与术前比较差异无统计学意义（P〈0．05）；EGF的含量术后明显高于术前（t=2．28，P〈0．05）。结论TNF-α和EGF水平可能提示肾小管细胞的自身炎症过程及与肾损害的发生机制密切相关。

Objective To discuss the change and the regulation of tumornecrosis factor（TNF-α） and epidermal growth factor（EGF） before and after extracorporeal shock wave lithotripsy. Method Radioimmunoassay was used to measure TNF-α in 50 cases urine sample before and after ESWL. Results TNF-α level in urine after ESWL were increased significantly at 1 - 4d（ t = 2.82, P 〈 0.05） compared to that before. That at 2d was significantly higher than that at 4d after ESWL（ t = 2.82, P〈 0.01 ）. TNF-α level was decreased at 5d and there was no significant difference compared with that before ESWL（P 〈 0.05 ）. The content of EGF before treatment was obviously lower than that after treatment（ t = 2.28, P 〈 0.05）. Conclusion The level of TNF-α, EGF showed renal tubules cell infective could be ralated with injury of renal.