Schwartz Bradley F, Dykes Thomas E, Rubenstein Jonathan N, Stackhouse G Bennett, Stoller Marshall L
Department of Urology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9665, USA.
Urology. 2007 Aug;70(2):227-9. doi: 10.1016/j.urology.2007.03.057.
To compare differential renal perfusion in various body positions in healthy volunteers, to help postulate factors responsible for recurrent unilateral stone formation.
Ten volunteers with normal renal function and no history of urinary disease were evaluated with diuretic renography using mercaptoacetyl-triglycine. Scintigraphy was performed 1 week apart in each of three typical sleep positions (supine, left lateral decubitus, right lateral decubitus), and renal perfusion was measured.
Symmetric renal perfusion was noted in all volunteers in the supine position. Subjects positioned in the left lateral decubitus position had a mean renal perfusion of 61.3% in the dependent (left) kidney, compared with 38.7% in the nondependent (right) kidney (P <0.05). In the right lateral decubitus position, the mean renal perfusion in the right kidney was 63.3%, whereas that in the left kidney measured 36.7% (P <0.05). Renal perfusion in the dependent kidney was increased when compared with the same kidney in the supine position in both the left and right kidneys.
Body position had a significant effect on renal perfusion as measured by nuclear renal scintigraphy. If altered renal blood flow contributes to urinary calculogenesis, these data suggest that the urinary and vascular milieu in the decubitus position may contribute to risk factors for stone formation.
比较健康志愿者在不同体位下的肾脏差异灌注，以推测复发性单侧肾结石形成的相关因素。
对10名肾功能正常且无泌尿系统疾病史的志愿者，使用巯基乙酰三甘氨酸进行利尿肾图评估。在三种典型睡眠体位（仰卧位、左侧卧位、右侧卧位）下，每隔1周进行一次闪烁扫描，并测量肾脏灌注。
所有志愿者在仰卧位时肾脏灌注对称。处于左侧卧位的受试者，受压（左）肾的平均肾脏灌注为61.3%，而非受压（右）肾为38.7%（P<0.05）。在右侧卧位时，右肾平均肾脏灌注为63.3%，而左肾为36.7%（P<0.05）。与仰卧位时同一侧肾脏相比，左、右两侧受压肾脏的灌注均增加。
通过核素肾闪烁扫描测量，体位对肾脏灌注有显著影响。如果肾血流改变导致尿石症发生，这些数据表明卧位时的尿液和血管环境可能是结石形成的危险因素。
