Mandal A K, Bennett W M
Department of Medicine, Veterans Administration Medical Center, Dayton, Ohio.
Nephron. 1988;49(1):67-73. doi: 10.1159/000184989.
Transmission electron microscopy was used to study urine sediment and renal tissue from Fischer rats treated with gentamicin or tobramycin 40 mg/kg/day or sterile water (control) subcutaneously for 5 or 10 days. Renal function was assessed by serum urea nitrogen and 24-hour creatinine clearance. Urine sediment was examined for myeloid bodies and renal tubule cells. After 5 days, the renal function was not different, but myeloid bodies, renal tubule cells, and abnormal renal morphology were found only in tobramycin-treated animals. After 10 days, serum urea nitrogen was higher (p less than 0.05) and creatinine clearance lower (p less than 0.01) in treated than control animals. Myeloid bodies and renal tubule cells were found uniformly in treated animals. Transmission electron microscopy kidneys revealed abnormalities in treated animals, but focal tubular necrosis was found only in gentamicin-treated animals. This study using urinary sediment transmission electron microscopy as a sensitive technique reveals that tobramycin produces earlier but less severe aminoglycoside nephrotoxicity than gentamicin. Renal pathological changes may occur despite the absence of major decreases in renal function.
采用透射电子显微镜观察了皮下注射庆大霉素或妥布霉素（40mg/kg/天）或无菌水（对照）5天或10天的Fischer大鼠的尿沉渣和肾组织。通过血清尿素氮和24小时肌酐清除率评估肾功能。检查尿沉渣中的髓样小体和肾小管细胞。5天后，肾功能无差异，但仅在妥布霉素治疗的动物中发现髓样小体、肾小管细胞和异常肾形态。10天后，治疗组动物的血清尿素氮更高（p<0.05），肌酐清除率更低（p<0.01）。在治疗组动物中均发现了髓样小体和肾小管细胞。透射电子显微镜观察显示治疗组动物的肾脏存在异常，但仅在庆大霉素治疗的动物中发现局灶性肾小管坏死。本研究将尿沉渣透射电子显微镜作为一种敏感技术，结果表明，与庆大霉素相比，妥布霉素产生的氨基糖苷类肾毒性更早但更轻。尽管肾功能没有明显下降，但仍可能发生肾脏病理变化。
