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部分输尿管梗阻的部位和严重程度对泌尿系统结石病形成的影响。

Effect of the location and severity of partial ureteral obstruction on urinary system stone disease formation.

作者信息

Demirhan Kemal, Saglam Hasan Salih, Cimen Haci Ibrahim, Elcin Bilge, Cokluk Erdem

机构信息

Department of Urology, School of Medicine, Sakarya University, Sakarya, Turkey.

Department of Pathology, Sakarya University Training and Research Hospital, Sakarya, Turkey.

出版信息

Sci Rep. 2025 Apr 4;15(1):11560. doi: 10.1038/s41598-025-96879-7.

Abstract

This study aimed to observe the effect of the location and severity of partial ureteral obstruction, based on ureteropelvic and ureterovesical junction strictures, on stone formation. Forty 8-week-old male rats were divided into five groups: control and mild/severe proximal or distal ureteral obstruction groups. A partial ureteral obstruction was created according to the type of obstruction by a surgical procedure. After 5 days of intraperitoneal glyoxylate injection, the urine, blood samples, and kidney tissues of the rats were examined. There were significant differences in urine citrate concentrations, pH values, and oxalate/creatinine, citrate/creatinine, and calcium/creatinine ratios between the groups (all p < 0.05). The mean citrate/creatinine ratio was 21.13 ± 0.44 in the control group, 17.31 ± 3.82 in the distal obstruction group, and 15.48 ± 1.87 in the proximal obstruction group. Regarding the degree of obstruction, urine citrate concentrations, pH values, and citrate/creatinine were lower, and the oxalate/creatinine ratio was higher in severe obstruction than in mild obstruction (p < 0.05). This study represents an initial attempt to evaluate a model of partial ureteral obstruction and urolithiasis. The findings indicate that obstruction alters urinary parameters, such as citrate and pH, indirectly increasing the risk of stone formation. Furthermore, stone formation in an obstructed urinary system appears to be a complex process. However, metabolic evaluation and treatment may help prevent stone formation in patients with ureteral obstruction.

摘要

本研究旨在观察基于肾盂输尿管和输尿管膀胱连接部狭窄的部分输尿管梗阻的部位和严重程度对结石形成的影响。将40只8周龄雄性大鼠分为五组:对照组、轻度/重度近端或远端输尿管梗阻组。通过外科手术根据梗阻类型造成部分输尿管梗阻。腹腔注射乙醛酸5天后,对大鼠的尿液、血液样本和肾脏组织进行检测。各组之间的尿枸橼酸盐浓度、pH值以及草酸盐/肌酐、枸橼酸盐/肌酐和钙/肌酐比值存在显著差异(均p < 0.05)。对照组的平均枸橼酸盐/肌酐比值为21.13±0.44,远端梗阻组为17.31±3.82,近端梗阻组为15.48±1.87。就梗阻程度而言,严重梗阻组的尿枸橼酸盐浓度、pH值和枸橼酸盐/肌酐较低,而草酸盐/肌酐比值高于轻度梗阻组(p < 0.05)。本研究是评估部分输尿管梗阻和尿路结石模型的初步尝试。研究结果表明,梗阻会改变尿液参数,如枸橼酸盐和pH值,间接增加结石形成的风险。此外,梗阻性泌尿系统中的结石形成似乎是一个复杂的过程。然而,代谢评估和治疗可能有助于预防输尿管梗阻患者的结石形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/607a/11971389/dcc291078cdd/41598_2025_96879_Fig1_HTML.jpg

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