Kaji D M, Xie H W, Hardy B E, Sherrod A, Huffman J L
Department of Urology, University of Southern California School of Medicine, Los Angeles.
J Urol. 1991 Aug;146(2 ( Pt 2)):544-7. doi: 10.1016/s0022-5347(17)37849-7.
The long-term effects of extracorporeal shock wave lithotripsy (ESWL*) on children treated for renal calculi are unclear. To study the long-term bio-effects of this mode of treatment on the immature animal we evaluated 30 New Zealand white rabbits at 7 weeks of age for weight, serum blood urea nitrogen and creatinine, and arterial blood pressure after which they underwent left nephrectomy. Each group of 5 rabbits received ESWL of varying levels (500 to 3,000 shock waves) to the remaining right kidney using the Northgate SD3 lithotriptor (spark gap mediated). One control group received no shock waves. At maturity (16 weeks) the aforementioned parameters were measured again, and the kidneys and any grossly abnormal adjacent organs were examined. We found no significant change in total animal growth, renal growth, renal function or perirenal organs in the post-ESWL groups versus the control group. All post-ESWL groups had an increase in mean arterial blood pressure versus the control group with 3 of 6 groups showing significant increases (p less than 0.05). Histological renal changes, seen at all energy levels of ESWL delivered, included interstitial fibrosis, tubular atrophy, glomeruli destruction, capsular thickening, perivascular fibrosis and mild arteriole wall thickening. Changes were proportional to the number of shocks received. We conclude that ESWL delivered to immature animals does not significantly affect renal growth and function but it can cause significant permanent histological renal changes even at low doses and may result in an increase in adult mean arterial blood pressure.
体外冲击波碎石术（ESWL*）对接受肾结石治疗的儿童的长期影响尚不清楚。为了研究这种治疗方式对未成熟动物的长期生物效应，我们评估了30只7周龄的新西兰白兔的体重、血清血尿素氮和肌酐以及动脉血压，之后对它们进行了左肾切除术。每组5只兔子使用Northgate SD3碎石机（火花隙介导）对剩余的右肾施加不同水平（500至3000次冲击波）的ESWL。一个对照组未接受冲击波。在成熟时（16周），再次测量上述参数，并检查肾脏和任何明显异常的相邻器官。我们发现，与对照组相比，ESWL后各组动物的总体生长、肾脏生长、肾功能或肾周器官均无显著变化。与对照组相比，所有ESWL后组的平均动脉血压均升高，6组中有3组显示出显著升高（p小于0.05）。在ESWL的所有能量水平下观察到的肾脏组织学变化包括间质纤维化、肾小管萎缩、肾小球破坏、包膜增厚、血管周围纤维化和轻度小动脉壁增厚。变化与接受的冲击波数量成正比。我们得出结论，对未成熟动物施加ESWL不会显著影响肾脏生长和功能，但即使在低剂量下也会导致显著的永久性肾脏组织学变化，并可能导致成年平均动脉血压升高。
