银杏达莫对体外冲击波碎石术致患者早期肾损伤的保护作用

The Protective Effects of Ginkgo Biloba against Early Renal Injury Induced by Extracorporeal Shock Wave Lithotripsy

目的探讨银杏达莫对体外冲击波碎石术(ESWL)导致早期肾损伤的保护作用及其可能作用机制。方法选取2016年1月-2017年1月上海浦东新区公利医院泌尿外科收治的60例单侧肾结石(<2cm)患者,随机分为实验组和对照组,每组30例,实验组患者静滴银杏达莫,每天2次,对照组患者在同时间节点静滴生理盐水。分别收集患者体外冲击波碎石术(ESWL)前2h,术后12和24h尿液标本10mL、血液标本8mL。采用ELISA法检测尿液标本中中性粒细胞明胶酶相关载脂蛋白(NGAL)、半胱氨酸蛋白酶抑制剂C(Cys-C)含量;血液标本中白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)、超氧化物歧化酶(SOD)、内皮素-1(ET-1)含量。结果实验组患者ESWL后12和24h尿液中NGAL及Cys-C浓度均低于对照组(P<0.01);实验组患者ESWL后12和24h血清中IL-6、TNF-α、MDA、ET-1浓度均低于对照组(P均<0.05);实验组患者ESWL后12和24h血清中SOD浓度高于对照组(P<0.05)。结论银杏达莫对ESWL术所致的早期肾损伤具有保护作用,其作用机制可能与干预炎症反应、清除氧自由基、增强机体抗氧化能力、保护肾脏血管内皮细胞有关。

Objective To investigate whether ginkgo Biloba has protective effects on early renal injury induced by extracorporeal shock wave lithotripsy and the mechanism of its protection. Methods Totally 60 patients with kidney stones（〈2 cm）hospitalized at Shanghai Pudong Public Hospital during the period from January 2016 to January 2017 were selected and randomly divided into medication group or control group.Each group consisted of 30 patients. The patients of the medication group underwent treatment with Ginkgo Biloba twice daily,while the patients in control group received Normal saline solution. Both groups＇ samples of 10 ml urine and 8 ml blood were collected before and immediately after ESWL,at 12 h and 24 h.ELISA was used to measure the concentration of NGAL and Cys-C in urine and the concentration of IL-6,TNF-α,MDA,SOD,ET-1 in blood. Results The study found that NGAL and Cys-C in the urine of the control group were significantly higher than medication group at 12 h and 24 h after ESWL（P〈0.01）. In the control group,serum IL-6,TNF-α,MAD,SOD were significantly higher than medication group at 12 h and 24 h after ESWL（P〈0.05）. The concentration of serum SOD in the medication group was higher than control group at 12 h and 24 h after ESWL（P〈0.05）. Conclusion Ginkgo biloba can effectively protect early renal injury caused by ESWL,and the mechanism may be through intervention of inflammatory reaction,the removal of oxygen free radicals,the enhancement of the body＇s antioxidant capacity and the protection of renal vascular endothelial cells.