Sancaktepe Sehit Prof. Dr. İlhan Varank Training and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey.
Necmettin Erbakan University, Meram Medical Faculty, Department of Pediatric Surgery, Konya, Turkey.
J Pediatr Surg. 2024 Nov;59(11):161616. doi: 10.1016/j.jpedsurg.2024.06.024. Epub 2024 Jul 8.
This study aimed to investigate the effects of N-acetylcysteine (NAC) and selenium (Se) on vesicoureteral reflux (VUR) nephropathy.
A total of 44 rabbits in 7 groups, namely group 1 (Control), group 2 (VUR + sterile urine), group 3 (VUR + sterile urine + NAC), group 4 (VUR + sterile urine + Se), group 5 (VUR + infected urine), group 6 (VUR + infected urine + NAC) and group 7 (VUR + infected urine + Se), were used. Tc Dimercaptosuccinic acid renal scan (DMSA), cystogram and urine culture were performed both at the beginning and end of the study. Left VUR was created surgically, and E. coli was inoculated in infected urine groups. NAC and Se were administered daily for 21 days. Malondialdehyde (MDA) measurement, inflammatory response scores (IRSs), and cicatrization response scores (CRSs) in renal tissues were evaluated.
VUR did not reduce left renal uptake values in neither group 2 nor group 5. MDA levels of the left kidney were significantly higher in group 5 compared to group 1 (p = 0.001). There was no significant difference in MDA levels between group 5 and group 6, and between group 5 and group 7. Left kidney IRSs were found to be higher in all other groups except group 2 compared to the control group (p < 0.001). Left kidney CRSs were significantly higher in group 5 compared to group 2 (p = 0.026), group 6 (p < 0.001) and group 7 (p = 0.006).
A decrease in renal functions was not observed in VUR, even if there was infection. When CRSs were evaluated, NAC and Se had protective effects in terms of scar formation in VUR nephropathy.
Experimental animal study.
N/A.
本研究旨在探讨 N-乙酰半胱氨酸（NAC）和硒（Se）对膀胱输尿管反流（VUR）肾病的影响。
将 44 只兔子分为 7 组，分别为第 1 组（对照组）、第 2 组（VUR+无菌尿液）、第 3 组（VUR+无菌尿液+NAC）、第 4 组（VUR+无菌尿液+Se）、第 5 组（VUR+感染性尿液）、第 6 组（VUR+感染性尿液+NAC）和第 7 组（VUR+感染性尿液+Se）。在研究开始和结束时，均进行了 Tc 二巯丁二酸肾扫描（DMSA）、膀胱造影和尿液培养。通过手术创建左侧 VUR，并在感染性尿液组中接种大肠杆菌。连续 21 天给予 NAC 和 Se 每日治疗。评估肾脏组织中的丙二醛（MDA）测量值、炎症反应评分（IRSs）和瘢痕形成反应评分（CRSs）。
VUR 既没有降低第 2 组也没有降低第 5 组左侧肾脏的摄取值。与第 1 组相比，第 5 组左侧肾脏的 MDA 水平明显更高（p=0.001）。第 5 组和第 6 组之间以及第 5 组和第 7 组之间 MDA 水平没有差异。除第 2 组外，所有其他组的左肾 IRSs 均高于对照组（p<0.001）。与第 2 组（p=0.026）、第 6 组（p<0.001）和第 7 组（p=0.006）相比，第 5 组的左肾 CRSs 明显更高。
即使存在感染，VUR 也不会导致肾功能下降。在评估 CRSs 时，NAC 和 Se 在 VUR 肾病的瘢痕形成方面具有保护作用。
实验动物研究。
无。
