Stock J A, Krous H F, Heffernan J, Packer M, Kaplan G W
Children's Hospital and Health Center, University of California at San Diego Medical Center, USA.
J Urol. 1995 Aug;154(2 Pt 2):716-8. doi: 10.1097/00005392-199508000-00101.
To understand better the relationship among radionuclide renal scan differential function, renal histology and the outcome of pyeloplasty we performed ipsilateral renal biopsies in a series of patients undergoing primary pyeloplasty. A total of 17 consecutive patients with unilateral ureteropelvic junction obstruction underwent renal biopsy at the time of pyeloplasty. Biopsies were examined systematically after sections were stained with hematoxylin and eosin, periodic acid, Schiff, Jones modified silver or Masson trichrome stains, and they were reviewed by 1 pathologist. Biopsy results were correlated with preoperative and postoperative radionuclide renal scan differential functions. Patient age ranged from 1 month to 7 years (mean 19.8 months). Renal biopsy was abnormal in 6 kidneys, of which 5 had a preoperative differential function of less than 33%. None of these kidneys had evidence of postoperative improvement in renal function on followup scans despite a technically successful result. All remaining 11 kidneys had normal biopsies and a preoperative differential function of greater than 44%. We conclude from these data that patients with ureteropelvic junction obstruction with a differential function of less than 35% have a high probability of significant histological changes on biopsy and a low probability of postoperative improvement in differential function.
为了更好地理解放射性核素肾扫描微分功能、肾脏组织学与肾盂成形术结果之间的关系，我们对一系列接受初次肾盂成形术的患者进行了同侧肾脏活检。共有17例连续的单侧输尿管肾盂连接处梗阻患者在肾盂成形术时接受了肾脏活检。活检组织在用苏木精和伊红、过碘酸、席夫、琼斯改良银或马松三色染色后进行系统检查，并由1名病理学家进行复查。活检结果与术前和术后放射性核素肾扫描微分功能相关。患者年龄从1个月至7岁（平均19.8个月）。6个肾脏的活检结果异常，其中5个术前微分功能低于33%。尽管手术技术成功，但在随访扫描中这些肾脏均无肾功能术后改善的证据。其余11个肾脏的活检结果均正常，术前微分功能大于44%。从这些数据中我们得出结论，输尿管肾盂连接处梗阻且微分功能低于35%的患者，活检时有显著组织学改变的可能性很高，而术后微分功能改善的可能性很低。
