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单侧输尿管梗阻解除后肾脏恢复的治疗方法:一项综述

The therapeutic approaches of renal recovery after relief of the unilateral ureteral obstruction: A comprehensive review.

作者信息

Kaeidi Ayat, Maleki Maryam, Shamsizadeh Ali, Fatemi Iman, Hakimizadeh Elham, Hassanshahi Jalal

机构信息

Physiology-Pharmacology Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

Department of Physiology and Pharmacology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

出版信息

Iran J Basic Med Sci. 2020 Nov;23(11):1367-1373. doi: 10.22038/ijbms.2020.41984.9926.

Abstract

Unilateral ureteral obstruction (UUO) as a clinical disorder can cause renal damage. The permanent injury occurs if the obstruction is not relieved. Renal injury can be reversed with UUO removal (RUUO). RUUO attenuates the renal hemodynamic and functional impairment and decreases the renal fibrosis and apoptosis. Nevertheless, kidney injury may continue after RUUO, and synchronous medication therapy seems necessary. However, UUO and post-RUUO periods are also important in final renal recovery. To date, various therapeutic strategies have been applied to develop renal recoverability after RUUO. In animal studies, the effect of some pharmacological agents such as mesenchymal stem cells, anti-inflammation drugs, L-arginine, bone morphogenetic protein-7, epidermal growth factor, allopurinol, renin-angiotensin system antagonists, and endothelin A/B receptor blocker were surveyed in RUUO model. Also, post-RUUO renal recoverability has been studied in human researches. In these studies, the effective strategies have focused on surgery for RUUO creation via urethrotomy, urethroplasty, stent balloon dilatation, and stenting. Accordingly, in this review, we focused on the therapeutic procedure of renal recovery after the RUUO situation in human and animal studies.

摘要

单侧输尿管梗阻(UUO)作为一种临床病症可导致肾损伤。如果梗阻不解除,就会发生永久性损伤。通过解除单侧输尿管梗阻(RUUO)可使肾损伤逆转。RUUO可减轻肾血流动力学和功能损害,并减少肾纤维化和细胞凋亡。然而,在RUUO后肾损伤可能仍会持续,同步药物治疗似乎很有必要。然而,UUO期和RUUO后期对最终的肾脏恢复也很重要。迄今为止,已应用各种治疗策略来提高RUUO后的肾脏恢复能力。在动物研究中,在RUUO模型中研究了一些药物制剂的作用,如间充质干细胞、抗炎药物、L-精氨酸、骨形态发生蛋白-7、表皮生长因子、别嘌呤醇、肾素-血管紧张素系统拮抗剂以及内皮素A/B受体阻滞剂。此外,在人体研究中也对RUUO后的肾脏恢复能力进行了研究。在这些研究中,有效的策略集中在通过尿道切开术、尿道成形术、支架球囊扩张术和置入支架来创建RUUO的手术上。因此,在本综述中,我们重点关注了人体和动物研究中RUUO后肾脏恢复情况的治疗过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e9a/7671422/cf23ffd0252f/IJBMS-23-1367-g001.jpg

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