依达拉奉辅助治疗对体外冲击波治疗肾结石所致肾损伤的保护作用研究

Study of protective effect of edaravone in treating renal injury caused by extracorporeal shock wave lithotripsy in renal calculi

目的:探讨依达拉奉辅助治疗对体外冲击波(extracorporeal shock wave lithotripsy,ESWL)治疗肾结石所致肾损伤的保护作用,为防止ESWL碎石对肾脏的损害提供一定依据。方法:119例肾结石患者按治疗方法分为对照组(n=53)和观察组(n=66)。对照组服用常规排石药物并给予ESWL治疗,观察组在对照组的基础上联合应用依达拉奉治疗。观察比较两组患者肾功能、自由基水平、ET-1、NO及炎性因子水平。结果:ESWL治疗24 h后,两组患者Scr、BUN及尿蛋白均显著升高,观察组患者Scr、BUN及尿蛋白等肾功能指标均显著低于对照组患者,差异均具有显著统计学意义(P<0.05)。两组患者SOD水平均显著降低,MDA水平均显著升高,观察组患者SOD水平显著高于对照组患者,MDA水平显著低于对照组患者,差异均具有显著统计学意义(P<0.05)。两组患者ET-1水平均显著升高,NO水平均显著降低,观察组患者ET-1水平显著低于对照组患者,NO水平显著高于对照组患者,差异均具有显著统计学意义(P<0.05)。两组患者TNF-α、IL-6与Hs-CRP水平均显著升高,观察组TNF-α、IL-6与Hs-CRP水平均显著低于对照组患者,差异均具有显著统计学意义(P<0.05)。结论:依达拉奉辅助治疗对ESWL治疗肾结石所致肾损伤具有明显保护作用,临床应用需要进一步研究。

Objective： To Study protective effect of edaravone in treating renal injury caused by extracorporeal shock wave lithotripsy（ESWL） in renal calculi. Methods： 119 cases of renal calculi were divided into control group（n =53） and observation group（n =66）. The control group was treated with lithagogue drugs and ESWL treatments, while the observation group was treated with edaravone, lithagogue drugs and ESWL treatments. Then, the renal function, levels of free radical, ET-1, NO and inflammation factors were compared. Results： 24 hours after ESWL treatments, levels of serum creatinin（Scr）, blood urea nitrogen（BUN）, and urine protein（UP） were significantly elevated. Levels of Scr, BUN, and UP of the observation group were significantly lower than those of the control group（P〉0.05）. 24 hours after ESWL treatments, level of superoxide dismutase（SOD） was significantly decreased and level of malondialde-hyde（MDA） was significantly increased. Compared to the control group, level of SOD was significantly higher and level of MDA was significantly lower in the observation group（P 0.05）. 24 hours after ESWL treatments, level of endothelin-1（ET-1） was significantly increased and level of nitric oxide（NO） was significantly decreased. Compared to the control group, level of ET-1 was significantly lower and level of NO was significantly higher in the observation group（P〉0.05）. 24 hours after ESWL treatments, levels of tumor necrosis factor-alpha（TNF-α）, interleukin-6（IL-6）, and high-sensitivity c-reactive protein（Hs-CRP） were significantly elevated. Levels of TNF-α, IL-6 and Hs-CRP of the observation group were significantly lower than those of the control group（P〉0.05）.Conclusion： Adjuvant therapy of edaravone in treating renal injury caused by ESWL in renal calculi is effective for protecting renal, which is worthy of further study in future.